Blood Pressure Readings: Why Lying Down Could Offer a Clearer Picture

Your routine doctor’s appointment is about to get a slight extension. Emerging research suggests that to get a full picture of your cardiovascular health, you might need to do more than just sit for a blood pressure check. Now, lying down could be just as important.

A recent 30-year study, presented at an American Heart Association meeting, has unveiled startling data. Missing out on blood pressure measurements in the supine (lying flat) position could leave certain patients – those at risk of coronary artery disease, heart failure, stroke, and premature death – undiagnosed and untreated.

Stephen Juraschek, MD, an associate professor at Harvard Medical School and the study’s lead investigator, expressed that the findings were surprising (ref). He emphasized that blood pressure readings taken while patients lie flat could reveal risks otherwise missed in standard seated measurements.

The statistics are concerning. Nearly half of U.S. adults over 20 – about 122 million people – are dealing with high blood pressure (ref), a condition that only escalates with age.

But here’s the twist: accurate blood pressure readings are complex. They’re vital for determining care for hypertension patients, be it through diet, lifestyle changes, or medication.

Yet, getting these readings right is crucial since every 20 mmHg increase in systolic blood pressure, or 10 in diastolic, doubles the risk of death from stroke or heart attack (ref).

The Most Accurate Predictor of Cardiovascular Health Yet

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Image Credit: Andrey_Popov/Shutterstock.

Previously, nighttime blood pressure was considered the best predictor of cardiovascular outcomes (ref). However, nighttime readings are inconvenient and uncomfortable for patients, leading to low compliance.

This led Juraschek and his team to ponder if a daytime supine blood pressure measurement could be equally telling.

In their study, involving 11,369 adults from the Atherosclerosis Risk in Communities (ARIC) study, the participants were assessed in both sitting and lying positions. The study defined hypertension as readings equal to or exceeding 130/80 mmHg.

Surprisingly, 16% of participants only showed high blood pressure when lying flat, a condition that would go unnoticed in a standard office visit.

These individuals with supine-only hypertension were found to have significantly higher risks of various heart conditions and even death compared to those with normal blood pressure in both positions.

An Italian study, published in Hypertension, adds another dimension. It found that a rise in systolic blood pressure upon standing, rather than the typical slight fall, signaled a higher risk of severe cardiovascular events.

Beyond Posture: Ensuring Accurate Measurements

Whether lying, sitting, or standing, consistency is key in blood pressure measurements (ref).

Factors such as correct cuff size, proper positioning, and avoiding certain activities before measurement (like eating, drinking, or exercising) are crucial for accuracy.

The Bigger Picture

High blood pressure is a leading risk factors of death worldwide (ref). Accurate identification and treatment are essential.

The next time you visit your doctor, a few extra minutes spent lying down or standing up after your initial reading could provide a clearer, more comprehensive view of your heart health.

Martha A. Lavallie
Martha A. Lavallie
Author & Editor | + posts

Martha is a journalist with close to a decade of experience in uncovering and reporting on the most compelling stories of our time. Passionate about staying ahead of the curve, she specializes in shedding light on trending topics and captivating global narratives. Her insightful articles have garnered acclaim, making her a trusted voice in today's dynamic media landscape.