Standing Blood Pressure More Predictive of Heart Disease Than Orthostatic increases
Table of Contents
Table of Contents
New research suggests that standing blood pressure readings may be a stronger indicator of cardiovascular disease (CVD) risk than orthostatic increases in blood pressure. This finding could challenge current clinical guidelines that combine these two measures into a single definition of orthostatic hypertension.
A long-term study, published online December 5, 2024, in the journal Hypertension [[1](https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.124.23409)], examined the relationship between both standing blood pressure and orthostatic blood pressure increases and CVD risk in over 11,000 middle-aged adults. The study,part of the Atherosclerosis Risk in Communities (ARIC) study,followed participants for an average of 24 to 28 years.
Standing Hypertension Linked to Higher CVD Risk
Researchers found that standing systolic blood pressure (SBP) readings of 140 mm Hg or higher were associated with a considerably increased risk of developing coronary heart disease, heart failure, stroke, fatal coronary heart disease, and all-cause mortality.
In contrast, orthostatic increases in SBP (a rise of 20 mm Hg or more when moving from lying down to standing) were not significantly associated with any CVD outcome, even though they were inversely associated with heart failure.
Distinguishing Measures Important for Clinical Care
“Contrary to the recent consensus definition, this finding underscores the importance of distinguishing between orthostatic increases and standing SBP [systolic BP] ≥ 140 mm Hg in clinic care and subsequent research,” the authors wrote. “[The study] findings raise concerns about combining these two components into a single definition, as the two may have distinct risk factors, underlying physiology, and downstream implications for CVD,” they further added.
The study authors noted that while their findings were based on a middle-aged cohort, the prevalence of standing hypertension is known to increase with age, making this a important consideration for older adults. They also suggested that further research with repeated blood pressure measurements is needed to confirm their findings.
The ARIC study was funded in part by the National Heart, Lung, and Blood Institute; National Institutes of Health; and Department of Health and Human Services.
## Measuring Risk: should We Rethink how We Define High Blood Pressure?
**Archyde:** Welcome back to Health Watch. Today, we’re diving into the latest developments in cardiovascular research, specifically concerning how we measure and understand high blood pressure.
Joining us is Dr. [Guest Name], a leading cardiologist and researcher who has dedicated their career to studying the complexities of hypertension. Dr. [Guest Name],welcome to the show.
**Dr. [Guest Name]:** Thank you for having me.
**Archyde:** Let’s address this new study that’s making waves in the medical community. Could you explain the findings and their potential impact on clinicians and patients alike?
**Dr. [Guest Name]:** This long-term study, following over 11,000 individuals for nearly three decades, has revealed somthing quite engaging. Standing blood pressure,so the reading taken when someone is standing upright,appears to be a more accurate predictor of cardiovascular risks like heart disease,stroke,and even death than previously thought. This finding, published in the *Journal of Hypertension*, challenges the current definition of orthostatic hypertension, which combines both standing blood pressure readings and orthostatic increases, meaning the jump in blood pressure experienced when moving from lying down to standing.
**archyde:** That’s quite striking. So,what does this mean for the way we approach diagnosing and managing high blood pressure in the future?
**Dr. [Guest Name]:** This research encourages us to rethink how we define and classify various forms of hypertension. These findings suggest that standing blood pressure readings exceeding 140 mm Hg might be a more reliable marker for cardiovascular risk than simply focusing on whether or not there’s a large increase in blood pressure upon standing.
This research warrants further inquiry,specifically with repeated blood pressure measurements to confirm these findings across different populations. Though, it presents a compelling argument for reevaluating the current consensus definition of orthostatic hypertension. We need to consider these factors separately to better understand their distinct risk profiles and guide individual patient care.
**Archyde:** this is truly groundbreaking details. Dr. [guest Name], thank you for your insights and expertise on this important topic.
**
**Note:** You can further tailor this interview segment by incorporating specific quotes from the study, framing it around a particular patient case, or inviting a second guest, perhaps a patient advocate, to offer a diverse perspective. Remember to maintain a clear and concise tone, ensuring accessibility for a broad audience.
**Q:** Dr. Smith, this new study suggests that standing blood pressure readings may be a better predictor of heart disease then the conventional focus on orthostatic increases. Can you elaborate on what this means?
**A:** Absolutely. This groundbreaking research, published in the journal *Hypertension*, followed over 11,000 individuals for almost three decades. They found that standing systolic blood pressure (SBP) readings of 140 mm Hg or higher were strongly linked to an increased risk of things like coronary heart disease, stroke, and even death. This was more meaningful than simply looking at how much blood pressure rises when someone stands up.
**Q:** So, does this mean we should stop worrying about those blood pressure spikes when we stand up?
**A:** Not necessarily. While the study didn’t find a strong link between orthostatic increases and cardiovascular disease,it’s still valuable to measure them.The authors suggest that these two measures might have diffrent underlying causes and should be considered separately for a more complete picture of a patient’s risk.
**Q:** What does this mean for how doctors diagnose and manage high blood pressure in the future?
**A:** This research definitely encourages us to re-think how we define and classify high blood pressure. We might need to pay more attention to standing blood pressure readings,especially in older adults,where high standing SBP is more common. Though, more research is needed to confirm these findings and fully understand the implications for clinical care.
**Q:** What advice would you give to patients who are concerned about their blood pressure?
**A:** it’s always important to talk to your doctor about your blood pressure readings and any concerns you might have.Don’t hesitate to ask about your standing blood pressure and what it means for your health. Remember, understanding your individual risk factors and working closely with your healthcare provider is key to preventing cardiovascular disease.
