Lying down and high blood pressure increase heart disease risk.

Lying down and high blood pressure increase heart disease risk.

Blood pressure while lying down

Image: Blood pressure while lying down may be just as important a measure of cardiovascular health as blood pressure while seated.

Blood pressure is a crucial measurement of our health, as it helps to determine the risk of poor health outcomes such as heart attack and stroke. Traditionally, blood pressure is measured while a person is sitting. However, recent research suggests that this method may not provide the full picture of cardiovascular health, as some individuals may have high blood pressure while lying down but normal blood pressure while sitting.

The findings presented at the American Heart Association’s Hypertension Scientific Sessions 2023 reveal that individuals with high blood pressure while lying down are still at risk for adverse cardiovascular events such as coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality, even if their blood pressure is normal while seated.

To better understand the implications of high blood pressure while lying down, it is important to grasp the concept of blood pressure. Blood pressure is measured using two numbers: systolic (when the heart muscles contract) and diastolic (when the heart is at rest). In a normal blood pressure reading, the average is 120/80 millimeters of mercury (mm Hg).

The study in question, which analyzed data from the Atherosclerosis Risk in Communities (ARIC) Study, included 11,369 participants without a history of coronary heart disease, heart failure, or stroke. The researchers defined high blood pressure while lying down (supine hypertension) as a reading equal to or greater than 130 mm Hg systolic or 80 mm Hg diastolic. High blood pressure while sitting was determined by the same parameters but in a seated position.

Out of the participants, 16% had normal blood pressure while seated but high blood pressure while lying down. The researchers also found that 74% of those with high blood pressure while sitting also had high blood pressure while lying down. Over an average follow-up period of 25-28 years, individuals with both seated and supine high blood pressure were at increased risk for coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality. Surprisingly, the risk was similar for individuals with high blood pressure only while lying down, regardless of whether they were using medication to manage their blood pressure or not.

Dr. Michael Broukhim, a board-certified interventional cardiologist, commented on the study, stating that it revealed a significant proportion of middle-aged adults could have hypertension that goes undetected when blood pressure is only measured while sitting. Dr. Cheng-Han Chen, an interventional cardiologist, also highlighted the study’s implications for blood pressure management strategies, emphasizing the importance of measuring blood pressure while lying down.

It is important to note that this study does not establish a causal relationship between high blood pressure while lying down and adverse cardiovascular events. Furthermore, the study has not yet undergone peer review. Dr. Keith C. Ferdinand, a professor of medicine at Tulane University, commented that while the study’s abstract is interesting, more confirmation is needed through full peer-reviewed analyses.

Despite the need for further research and potential barriers to implementation in clinical settings, such as time constraints for healthcare professionals, the study suggests that measuring blood pressure while lying down could provide a more comprehensive assessment of cardiovascular health. Dr. Broukhim proposed that obtaining supine blood pressure measurements in patients with normal seated blood pressure could be reasonable in certain cases. Additionally, Dr. Chen suggested adopting supine blood pressure measurements as a standard technique whenever possible, recognizing the potential impact of these findings on future blood pressure readings.

Concerned individuals can consult with their doctors about options for accurate blood pressure measurement. If blood pressure is high, doctors can develop personalized treatment plans involving medications and lifestyle changes such as quitting smoking and limiting alcohol consumption.

In conclusion, while blood pressure measurements obtained while sitting have long been the standard, research indicates that measuring blood pressure while lying down could provide additional insights into cardiovascular health. This supplementary assessment may help identify individuals at risk for adverse cardiovascular events and enable healthcare professionals to implement targeted interventions. Further studies are needed to confirm these findings and establish the causality between high blood pressure while lying down and poor health outcomes.