2023 Volume 60 Issue 2 Pages 71-75
The Japanese medical term Hiesho means cold hypersensitivity in the extremities and easily feeling cold in people without any pathological disorders. Hiesho is reported to occur in about 60% of healthy women and 20% of healthy men. People with Hiesho often have lower body weight and body mass index and are less active than people without Hiesho, and they also have associated symptoms, such as shoulder stiffness, easy fatigability, headache, constipation, depressive mood, lumbago, and dizziness. Measurements of heart rate, R-R interval variability (on electrocardiogram), and skin blood flow (by laser Doppler) showed that the pathophysiological mechanism of Hiesho is sympathetic hyperactivity, which contributes to subjective coldness and decreased skin temperature. A reperfusion study after transient arm ischemia revealed greater vascular endothelial dysfunction in younger participants than in older ones. In sympathetic nerve recordings, skin sympathetic nerve activity in response to body cooling increased significantly larger in younger people than in older ones. These findings indicate that excessive elevation of skin sympathetic nerve activity in younger people is related to decreased skin blood flow in the extremities.
