A comprehensive 30-year research study conducted in collaboration with the American Heart Association (AHA) has recommended a dual approach to measuring blood pressure. Physicians should not only assess blood pressure when patients are in an upright sitting position but also when they are lying down flat. This approach becomes crucial because some individuals who exhibit seemingly normal blood pressure readings while seated may actually have elevated blood pressure when supine.
Lead study author Duc M. Giao, a medical student at Harvard Medical School, emphasized the significance of this dual assessment, stating, “If blood pressure is only measured when people are seated upright, cardiovascular disease risk may be missed.”
The study, involving more than 11,000 adults from diverse backgrounds in the U.S., unfolded a concerning correlation. Individuals with high blood pressure readings in both seated and supine positions faced a heightened risk of heart disease, stroke, heart failure, or premature death compared to those without high blood pressure in either position.
These findings were unveiled at the AHA’s Hypertension Scientific Session 2023, held from September 7-10. Researchers elaborated on the role of the autonomic nervous system in regulating blood pressure across different body postures. However, they noted that gravity could cause blood to accumulate when seated or upright, and the body sometimes struggled to maintain blood pressure levels in various positions—sitting, lying, or standing.
Key findings from the research include:
- 16% of participants who exhibited normal blood pressure readings (measuring below 130/80 mm Hg) while seated displayed high blood pressure when lying down flat on their backs. In contrast, approximately 74%, or three out of four, of those with high blood pressure in seated positions also had elevated supine hypertension.
- Participants with high blood pressure in both seated and supine positions faced a 1.6 times higher risk of developing coronary heart disease and a 1.83 times higher risk of overall premature death. They also had a 2.18 times higher risk of succumbing to coronary heart disease compared to subjects who did not exhibit high blood pressure in either posture.
- Intriguingly, adults who displayed high blood pressure exclusively when lying down, but not when seated, experienced the same elevated risks as those who had high blood pressure in both positions.
The study, which initiated its first phase in 1987 and concluded in 1989, involved 15,972 adults from diverse backgrounds in the U.S., with data collected in both rural and urban clinics. Subsequently, their health was monitored for an average period of 25 to 28 years, with the most recent health data being gathered between 2011 and 2013.
Duc M. Giao recommended that individuals with known risk factors for heart disease and stroke consider having their blood pressure assessed while lying flat on their backs. He suggested that managing blood pressure during daily life could potentially help lower blood pressure during sleep. Future research should also compare supine blood pressure measurements in clinical settings with overnight measurements.
However, it’s important to note that one limitation of this study is that the average age of participants was 54, and results may vary for older populations.
According to the Centers for Disease Control and Prevention, high blood pressure increases the risk of heart disease and stroke. In 2021, hypertension played a role in 691,095 deaths in the U.S., and nearly half of adults have hypertension, defined as having a systolic blood pressure greater than 130 mm Hg or a diastolic blood pressure greater than 80 mm Hg.
{Matzav.com}
