Blood pressure taken lying down is a better predictor of cardiovascular disease
Supine hypertension is a greater hazard for cardiovascular disease with or without seated hypertension.
An original investigation published in JAMA (Journal of the American Medical Association) Cardiology provides evidence that supine blood pressure measurement reveals risks for cardiovascular disease that are missed by taking blood pressure while seated. The authors state:
“Nocturnal hypertension while asleep is associated with substantial increases in risk of cardiovascular disease (CVD) and death. Whether hypertension while supine is a risk factor associated with CVD independent of seated hypertension remains unknown.”
They set out to determine if high blood pressure is present while simply supine is a risk factor independent of seated hypertension. They measured supine and seated blood pressure in more than 13,000 middle-aged adults with surveillance for CVD over 27 years. Hypertension was defined as systolic blood pressure ≥130 or diastolic blood pressure ≥80 mm Hg.
The results are worthy of attention by clinicians when evaluating CVD risk:
“In this cohort study of 11 369 middle-aged adults, supine hypertension without seated hypertension was associated with incident coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality.”
Moreover…
“Results did not differ by antihypertensive medication use, and supine hypertension alone without seated hypertension was associated with cardiovascular outcomes similarly to having hypertension in both positions.”
Quoted in Medscape Family Medicine, the authors stated:
"While hypertension in both seated and supine positions was associated with the highest risk of adverse events, having supine hypertension without seated hypertension and independent of seated BP [blood pressure] was also a potent risk factor associated with CVD [cardiovascular disease]. For most outcomes, the risk was quite similar to that associated with having hypertension in both positions," the authors wrote.
"Given the simplicity of performing a supine BP in the clinic and the opportunity to detect occult hypertension, supine hypertension warrants greater attention," they added.
