Abstract 071: Seated And Supine Blood Pressure And Risk Of Cardiovascular Disease And Mortality From The Atherosclerosis Risk In Communities Study

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2023-09, Vol.80 (Suppl_1)
• Main Authors: Giao, Duc M, Col, Hannah, Larbi Kwapong, Fredrick, Turkson-Ocran, Ruth-Alma, Ngo, Long H, Cluett, Jennifer, Wagenknecht, Lynne, Windham, B Gwen, Selvin, Elizabeth, Lutsey, Pamela L, Juraschek, Stephen P
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.80.suppl_1.071

Abstract only Background: Hypertension (HTN) while asleep is strongly associated with cardiovascular disease (CVD) and death. Whether HTN while supine in clinic is a risk factor for CVD independent of seated BP remains unknown. Objectives: To determine the relationship between supine HTN and adverse CVD. Methods: The Atherosclerosis Risk in Communities (ARIC) Study measured supine and seated BP during visit 1 (1987-1989). Supine HTN was defined as a supine systolic BP (SBP) ≥130 or diastolic BP (DBP) ≥80 mm Hg and seated HTN was defined as a seated SBP ≥130 or DBP ≥80mm Hg. We excluded participants with a history of coronary heart disease (CHD), heart failure, or stroke and examined the association of supine HTN with incident CHD, heart failure, stroke, fatal CHD, and all-cause mortality using Cox models adjusted for seated HTN and CVD risk factors. Analyses were repeated in strata of HTN treatment. Results: Of 11,369 participants (56% female, 25% Black, mean age [53.9±5.7 years]), 16% of those without seated HTN had supine HTN, while 74% of those with seated HTN had supine HTN. Over a median of 25-28 years of follow-up, despite adjustment for seated HTN, supine HTN was associated with incident CHD (HR 1.60; 95% CI: 1.45, 1.76), heart failure (1.83; 1.68,2.01), stroke (1.86; 1.63, 2.13), fatal CHD (2.18; 1.84, 2.59), and all-cause mortality (1.43; 1.35,1.52). Results did not differ by HTN medication use ( P -interactions >0.05). Participants with supine HTN alone, had a risk similar to HTN in both positions ( Figure ). Conclusion: Participants with supine HTN had a significantly higher risk of adverse CVD events independent of seated HTN. Supine HTN screening should be further evaluated in a clinical trial.