Differences in Blood Pressure by Body Position (Supine, Fowler's, and Sitting) in Hypertensive Subjects.
Summary of "Differences in Blood Pressure by Body Position (Supine, Fowler's, and Sitting) in Hypertensive Subjects."
BackgroundAlthough 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.MethodsSystolic 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.ResultsThe 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 ± 13.7 mm Hg, respectively, and mean DBPs 80.1 ± 9.1; 81.9 ± 9.4; 83.0 ± 9.6 mm Hg, 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 ≥10 mm Hg) 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).ConclusionsFowler'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 (2011). doi:10.1038/ajh.2011.106.
Affiliation
Department of Medicine and Science of Aging, University "G. d'Annunzio" of Chieti, Chieti, Italy.
Journal Details
This article was published in the following journal.
Name: American journal of hypertension
ISSN: 1879-1905
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21677699
- DOI: http://dx.doi.org/10.1038/ajh.2011.106
Medical and Biotech [MESH] Definitions
Hypotension, Orthostatic
A significant drop in BLOOD PRESSURE after assuming a standing position. Orthostatic hypotension is a finding, and defined as a 20-mm Hg decrease in systolic pressure or a 10-mm Hg decrease in diastolic pressure 3 minutes after the person has risen from supine to standing. Symptoms generally include DIZZINESS, blurred vision, and SYNCOPE.
Postural Balance
A POSTURE in which an ideal body mass distribution is achieved. Postural balance provides the body carriage stability and conditions for normal functions in stationary position or in movement, such as sitting, standing, or walking.
Pressure Ulcer
An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stay in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure.
Supine Position
The posture of an individual lying face up.
Central Venous Pressure
The blood pressure in the central large VEINS of the body. It is distinguished from peripheral venous pressure which occurs in an extremity.
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