Daily Dose: High Blood Pressure While Lying Down Raises Risk for CVD Events

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On September 8, 2023, we reported on a study presented at the American Heart Association's Hypertension Scientific Sessions 2023 that examined the association between body position, blood pressure (BP), and cardiovascular disease (CVD) risk.

The study

Researchers analyzed health data for 11 369 participants from the Atherosclerosis Risk in Communities (ARIC) study. They gathered data on supine and seated BP, both defined as at least 130 mm Hg systolic or at least 80 mm Hg diastolic as measured from the respective position, which was assessed at their first visit from 1987 to 1989. All participants had no history of coronary heart disease (CHD), heart failure (HF), or stroke at baseline. Participants were followed for an average of 25 to 28 years.

Findings

• 16% of participants who did not have hypertension (HTN) while seated had HTN while lying supine, compared to 74% of those with seated HTN who also had supine HTN.

• Compared to participants who did not have seated HTN or supine HTN, those who did have seated HTN or supine HTN faced a 1.6-times higher risk of developing CHD; a 1.83-times higher risk of developing HF; a 1.86-times higher risk of stroke; a 1.43-times higher risk of overall premature death; and a 2.18-times higher risk of dying from CHD.

Authors' comment

“Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs. Efforts to manage blood pressure during daily life may help lower blood pressure while sleeping. Future research should compare supine blood pressure measurements in the clinic with overnight measurements.”

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