Differences in Blood Pressure by Body Position (Supine, Fowler's, and Sitting) in Hypertensive Subjects

Background Although blood pressure (BP) differences from supine to sitting position have long been recognized, limited data are available on other commonly used body positions. We performed a cross-sectional study to compare BP values obtained in supine, sitting, and Fowler's positions in essen...

Full description

Saved in:
Bibliographic Details
Published in:American journal of hypertension 2011-10, Vol.24 (10), p.1073-1079
Main Authors: Cicolini, Giancarlo, Pizzi, Carmine, Palma, Elisabetta, Bucci, Marco, Schioppa, Francesco, Mezzetti, Andrea, Manzoli, Lamberto
Format: Article
Language:English
Subjects:
Adult
Aged
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Blood Pressure Determination
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Cross-Sectional Studies
Female
Humans
Hypertension - physiopathology
Male
Medical sciences
Middle Aged
Multivariate Analysis
Posture
Supine Position
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Although blood pressure (BP) differences from supine to sitting position have long been recognized, limited data are available on other commonly used body positions. We performed a cross-sectional study to compare BP values obtained in supine, sitting, and Fowler's positions in essential hypertensive subjects. Methods Systolic BP (SBP) and diastolic BP (DBP) were recorded using an automatic oscillometric device. Nine measurements were taken: three measurements, in random order, in supine, Fowler's, and sitting position. Two generalized estimating equations models were used to evaluate potential predictors of SBP and DBP adjusting for heart rate and measurement order. Results The sample consisted of 250 subjects (mean age 66.3 ± 13.4 years; 44.4% males). Measured in supine, Fowler's, and sitting position, mean SBPs were 139.3 ± 14.0; 138.1 ± 13.8; 137.2 ± 13.7mmHg, respectively, and mean DBPs 80.1 ± 9.1; 81.9 ± 9.4; 83.0 ± 9.6mmHg, respectively. At multivariate analysis, mean SBP significantly decreased if measured in Fowler's and sitting positions, as compared to supine. In contrast, DBP significantly increased. A relevant proportion of subjects showed large differences (≤ or ≥10mmHg) in mean SBP across positions: i.e., 30.0% comparing supine vs. sitting SBP. An even higher prevalence of large differences was observed according to the measurement order within the same positions, with no univocal direction (random variation). Conclusions Fowler's position may represent a valid alternative to sitting and supine positions for BP measurement in clinical practice. BP random variability was found to be large regardless of body position, reinforcing the need for operators to closely follow current guidelines that recommend ≥2 recordings at each measurement. American Journal of Hypertension advance online publication 16 June 2011; doi:10.1038/ajh.2011.106
ISSN:0895-7061
1879-1905
1941-7225
DOI:10.1038/ajh.2011.106