Blood pressure is an important health indicator. To lower the risk of bad health outcomes such as heart attack and stroke, people must keep their blood pressure within a reasonable range.
A recent research discovered that persons with normal sitting blood pressure but high laying blood pressure are nevertheless at risk for poor health outcomes such as coronary heart disease, heart failure, and fatal coronary heart disease.
More study is needed to determine how useful it would be to assess supine blood pressure in the clinical context on a frequent basis.
Blood pressure is often measured by medical practitioners to acquire critical information about a person’s health. During blood pressure measurements, most people are seated.
However, this may not provide a complete picture of a person’s cardiovascular health because some persons have high blood pressure while laying down and normal blood pressure while sitting.
According to study findings presented at the American Heart Association’s (AHA) Hypertension Scientific Sessions 2023Trusted Source, people who only have high blood pressure while lying down have the same risk for heart failure, stroke, coronary heart disease, fatal coronary heart disease, and all-cause mortality as people who have high blood pressure while sitting and lying down.
What if someone gets high blood pressure when lying down?
High blood pressureThe force of blood pressing on the blood arteries that transport blood away from the heart is measured by Trusted Source. The systolic number, which measures when the heart muscles contract, and the diastolic number, which measures when the heart is at rest, are both used to calculate blood pressure.
When someone’s blood pressure is normal, it should be 120/80 millimeters of mercury (mm Hg).
Researchers sought to investigate if elevated blood pressure while lying down, often known as supine hypertension, was a risk factor for unfavorable cardiovascular disease on its own. In other words, would someone with high blood pressure when lying down be at risk of bad health outcomes?
The Atherosclerosis Risk in Communities (ARIC) StudyTrusted Source was used by the researchers. They ended up enrolling 11,369 people in their study.
Individuals having a history of coronary heart disease, cardiac failure, or stroke were excluded. Supine high blood pressure was defined by researchers as any measurement more than or equal to 130 mm Hg systolic or greater than or equal to 80 mmHg diastolic while lying down. They used the same factors to identify seated high blood pressure, but this time when sitting rather than lying down.
Researchers discovered that 16% of the subjects had normal blood pressure while seated but elevated blood pressure while lying down. They also discovered that 74% of subjects with high blood pressure while sitting had high blood pressure while lying down.
The average length of follow-up was 25-28 years. People with sitting and supine high blood pressure were shown to be more likely to develop coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality.
Participants who solely had elevated blood pressure when lying down faced the same risk. The researchers also discovered that the outcomes were unaffected by the usage of high blood pressure medication.
Dr. Michael Broukhim, a board-certified interventional cardiologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, told Medical News Today about the findings:
“High blood pressure increases the risk of cardiovascular disease, such as coronary artery disease, stroke, kidney disease, heart failure, and premature death.” This study shows that sitting blood pressure measurements may miss hypertension in a considerable number of middle-aged persons.”
Dr. Cheng-Han Chen, interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, California, who was not involved in the study, said that the findings have significant implications for blood pressure control tactics.
“This research shows that we may miss the diagnosis of hypertension in many patients if we only measure their blood pressure while sitting, rather than laying down,” he explained. “This gives us an important opportunity to better address an important cardiovascular risk factor.”
Causality is yet unknown.
Nonetheless, the study cannot demonstrate a causal association between any of the characteristics studied by the researchers. More blood pressure readings appear to have yielded even more reliable information.
Furthermore, the paper has yet to be peer reviewed.
Dr. Keith C. Ferdinand, a Tulane University School of Medicine professor who was not engaged in the research, told MNT about the study presented at the AHA conference:
“Study abstracts are always fascinating to read. Full peer-reviewed analyses are required for confirmation. Supine blood pressure would appear to be a danger because blood pressure is traditionally lower in that posture than in a sitting position. And it might be a proxy for someone whose blood pressure does not fall adequately when completely resting, especially during the night.”
Will laying down to take your blood pressure become commonplace?
This study suggests that measuring blood pressure when patients are lying down may be beneficial in obtaining a more full picture of their cardiovascular health. However, there are certain obstacles to putting this into practice in a clinical context.
According to Dr. Ferdinand, “[c]linicians are currently under great time constraints.”
“[They are] frequently employed by integrated healthcare systems who monitor the number of patients seen on a regular basis and make reimbursement assessments based on a 15-minute conventional visit,” he explained.
“adding the supine blood pressure would be difficult because it would not only complicate the intake […] but would provide additional information that the clinician may not have time to appropriately analyze and make a decision,” he stated.
Dr. Broukhim did caution, however, that for some people, taking blood pressure measures while lying down may be feasible.
“I think it is reasonable to obtain a supine blood pressure in patients presenting to the office if they have a normal seated blood pressure,” he said. “If there is a high clinical suspicion of hypertension, an ambulatory systolic blood pressure monitor should be used, which will likely show if the patient has supine hypertension while at home.”
Similarly, Dr. Chen stated, “These findings may play a significant role in how we take blood pressure readings in the future.” While not always practical, we should definitely use supine blood pressure readings as a routine procedure whenever possible.”
People who are concerned about their blood pressure should see their doctor about precise measuring alternatives. People with high blood pressure can work with their doctor to build a personalized treatment plan. This may entail taking specific drugs as well as making lifestyle changes such as stopping smoking and restricting alcohol use.