December 14, 2023

The Correlation between Lying Down and High Blood Pressure: A Risk Factor for Heart Disease

Medical professionals, including doctors from the heart care center in Goodyear, commonly measure blood pressure while individuals are seated, but this may not provide a comprehensive view of cardiovascular health. Research presented at the American Heart Association’s Hypertension Scientific Sessions 2023 revealed that some people may have high blood pressure solely when lying down, while their readings are normal in a seated position. 

Surprisingly, individuals displaying high blood pressure solely while lying down face a similar risk of heart failure, stroke, coronary heart disease, fatal coronary heart disease, and all-cause mortality as those with high blood pressure in sitting and lying down poses. This indicates that blood pressure readings while lying down could be crucial in assessing cardiovascular health.

What implications arise if an individual experiences high blood pressure while lying down?

High blood pressure, or hypertension, is a crucial health metric often assessed while individuals are seated. It’s measured using two numbers: systolic pressure, indicating blood force when the heart contracts, and diastolic pressure, representing heart relaxation. A typical reading is 120/80 millimeters of mercury (mm Hg) for normal blood pressure.

The investigation sought to understand the significance of high blood pressure while lying down, also termed supine hypertension, as an independent risk factor for adverse cardiovascular outcomes. Data from the Atherosclerosis Risk in Communities (ARIC) Study were utilized, encompassing 11,369 participants without a history of coronary heart disease, heart failure, or stroke.

Supine high blood pressure was defined as readings ≥130 mm Hg systolic or ≥80 mm Hg diastolic when lying down. Similarly, seated high blood pressure was categorized by the same thresholds as in a sitting position. Among the participants, 16% had high blood pressure only while lying down, while 74% with seated high blood pressure exhibited supine hypertension.

The study revealed notable risks associated with supine hypertension. Participants with high blood pressure while both seated and lying down faced increased risks of various cardiovascular conditions compared to those without this hypertension profile. This included a 1.6 times higher risk of coronary heart disease, 1.83 times higher risk of heart failure, 1.86 times higher risk of stroke, 1.43 times higher risk of premature death, and 2.18 times higher risk of fatal coronary heart disease.

Remarkably, these risks were akin to individuals solely exhibiting high blood pressure while lying down, implying a substantial risk factor independent of seated measurements. Over a 25–28 year follow-up period, individuals with both seated and supine high blood pressure demonstrated increased risks for coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality.

The research suggests that relying solely on seated blood pressure measurements may overlook significant cases of hypertension in middle-aged adults. This underscores the importance of incorporating lying-down measurements to better understand cardiovascular risks. Even the use of medication for high blood pressure did not alter the observed risks.

Hypertension is intrinsically linked to increased risks of various cardiovascular diseases and premature death. This study highlights the potential oversight when solely measuring seated blood pressure, missing crucial hypertension diagnoses. Accurate assessments across different body positions—lying, sitting, and standing—are vital to accurately diagnose and address hypertension, as the autonomic nervous system regulates blood pressure differently in various positions.

Gravity can influence blood pressure regulation, causing blood to pool in seated or upright positions. This, in turn, may impact the body’s ability to regulate blood pressure effectively during lying, sitting, and standing positions.

In essence, understanding blood pressure changes across various body positions is crucial for comprehensive cardiovascular health assessments. Incorporating supine measurements alongside seated readings can provide a more holistic understanding of an individual’s blood pressure profile, enabling more effective management of hypertension and associated cardiovascular risks.

The exact cause and effect are yet to be determined

The study, while shedding light on the correlation between seated and supine blood pressure and various cardiovascular risks, falls short of establishing a definitive cause-and-effect relationship among the examined factors. Additionally, conducting more blood pressure measurements could potentially offer more precise insights into this correlation.

Moreover, it’s essential to note that the study has yet to undergo peer review, a critical step in validating its findings within the scientific community. One might assume that elevated supine blood pressure poses a risk, given the conventionally lower blood pressure observed in that position compared to sitting. This could signify a case where an individual’s blood pressure fails to appropriately lower during complete rest, including the nocturnal period, which might indicate an underlying risk factor for certain cardiovascular conditions.

While the research presents compelling associations between supine blood pressure and adverse health outcomes, it’s vital to approach these findings cautiously until further studies validate and elucidate the causal relationships. Additional comprehensive examinations and peer review processes are necessary to confirm and strengthen these initial observations.

Is it likely that measuring blood pressure while lying down will become a standard practice?

The recent study’s findings have unveiled a potential shift in blood pressure measurement protocols, suggesting that incorporating supine blood pressure readings could offer a more comprehensive understanding of an individual’s cardiovascular health. Yet, practical obstacles hinder its seamless integration into clinical practice.

Introducing supine blood pressure measurements poses challenges, notably complicating the initial patient intake process and potentially inundating clinicians with additional data that require thorough analysis, sometimes unfeasible within time constraints. However, it might be plausible to consider supine blood pressure assessments for specific cases, especially in patients who present normal seated blood pressure but raise clinical suspicion of hypertension.

Implementing supine blood pressure readings could prove beneficial for certain individuals, warranting consideration in clinical settings. For instance, patients exhibiting normal seated blood pressure levels could benefit from occasional supine blood pressure assessments, particularly when hypertension is suspected. In cases of elevated clinical suspicion, deploying an ambulatory systolic blood pressure monitor might be prudent, offering insights into supine hypertension when the patient is at home.

While not universally applicable across all healthcare settings, integrating supine blood pressure measurements into routine assessments where feasible might enhance the accuracy of blood pressure evaluations. These findings could potentially reshape how we gauge blood pressure in the future, although practical implementation remains nuanced and context-dependent.

Individuals concerned about their blood pressure are encouraged to engage in discussions with their doctors from the heart care center in Goodyear to explore accurate measurement options. In cases of elevated blood pressure, collaborating with a healthcare professional from a cardiovascular clinic in Goodyear to develop a personalized treatment strategy is pivotal. Such strategies often encompass tailored medication plans alongside lifestyle modifications, including smoking cessation and alcohol limitation, tailored to individual health needs.

As we navigate these potential shifts in blood pressure measurement practices, further research and consideration of practical implications in diverse healthcare settings will be imperative. This approach ensures that new techniques, while promising, are effectively integrated and utilized to optimize patient care and clinical decision-making.

Final Thoughts

To delve deeper into the link between high blood pressure and the risk of heart disease, connect with our knowledgeable specialists at our cardiovascular clinic in Goodyear. Our experts are available to offer expert guidance and insights on this critical health concern.