Supine High BP Increases CVD Risk and Mortality

A US prospective cohort analysis suggested that supine high blood pressure (BP) regardless of seated high BP was associated with a higher risk of CVD and mortality than seated high BP alone. The analysis used data from 11 369 participants without known CVD (female 55.7%, male 44.3%; Black 25.1%, White 74.9%; mean age 53.9 years), 16.4% of those without seated high BP had supine high BP and 73.5% of those with seated high BP had supine high BP. Supine high BP was associated with incident coronary heart disease (CHD, hazard ratio [HR], 1.60), heart failure (HR, 1.83), stroke (HR, 1.86), fatal CHD (HR, 2.18), and all-cause mortality (HR, 1.43) during a median follow-up of 25.7, 26.9, 27.6, 28.3, and 28.3 years, respectively. There were no meaningful differences by seated high BP status. Results were similar by high BP medication use. Participants with supine high BP alone had risk associations similar to those of participants with high BP in both positions and significantly greater than those of participants with seated high BP alone with the exception of fatal CHD; seated vs supine HRs were 0.72 for CHD, 0.72 for heart failure, 0.66 for stroke, and 0.83 for all-cause mortality. It is known that nocturnal high BP while asleep is associated with substantial increases in risk of CVD and death. Source: https://jamanetwork.com/