A surprising finding about taking blood pressure lying down

让某人躺下测血压这个简单的动作可能会揭示出比预期更多的心脏健康状况, 初步研究发现.

使用数据从一个大, 长期的研究, 研究人员发现，与坐着时的读数相比, 显示躺着的人血压高的读数在预测中风方面做得更好, 严重的心脏问题和死亡.

The results will be presented Saturday at the 美国心脏协会's 高血压科学会议 在波士顿. 在完整的研究结果发表在同行评议的期刊上之前，这项工作被认为是初步的.

Dr. Stephen Juraschek, 这项工作的高级研究员, 他说，研究结果令人惊讶，并建议让人们平躺测量血压，可能有助于识别那些需要治疗的人，尽管他们坐着测量的血压看起来很正常.

控制高血压, 或高血压, has long been understood to be an essential part of heart health. 但 getting an accurate reading from a seated position can be complicated, 说Juraschek, 她是波士顿贝斯以色列女执事医疗中心的普通内科医生，也是哈佛医学院的副教授.

As defined by the AHA and American College of Cardiology, 成年人坐着测量的正常血压是收缩压小于120mmhg，舒张压小于80mmhg. Readings fluctuate throughout the day, though.

Juraschek说 the "gold standard" for accuracy is ambulatory blood pressure, which takes readings throughout the day. 但 that requires wearing a monitor for 24 hours.

多年来, 他说, 研究一次又一次地表明，夜间血压测量是心血管疾病的最佳预测指标之一. 但 it's hard to get such readings. "It's not comfortable to have your arm compressed repeatedly overnight,他说. “它会影响你的睡眠."

Juraschek和他的同事们想要奠定基础，以确定是否仅仅让人们在白天躺在诊所里就能识别出那些患心血管疾病的风险更高, similar to blood pressure measurements taken during sleep.

他们首先比较了坐着和躺着或仰卧时的读数.

研究人员查阅了11369名社区动脉粥样硬化风险研究参与者的数据. 他们的血压是在他们坐着和躺着的时候测量的.

参与者的平均年龄为54岁，随访沙巴足球体育平台中位数为25至28年. People with a history of heart disease, heart failure or stroke were excluded. More than half of the participants were women and one-fourth were Black.

参与者被分为四组:一组坐着和躺着时血压读数正常. One had high blood pressure only while sitting. 第三种人——占参与者的16%——只有躺着的时候才会有高血压. And the fourth had high blood pressure in both positions.

随着沙巴足球体育平台的推移，两种姿势中没有高血压的一组风险最低. The group with high blood pressure in both positions consistently was at high risk.

但出乎意料, Juraschek说, 只有躺着时才有高血压的那组人的风险水平与两种姿势都有高血压的人相似, even after accounting for other cardiovascular risk factors. 只有仰卧位的高血压患者患冠心病的风险要高出53%, 心力衰竭的风险增加51%, 中风的风险增加62%, 78% higher risk of fatal coronary heart disease, 与两种体位血压正常的参与者相比，他们死于各种原因的风险都高出34%.

The risk of problems predicted by supine blood pressure, 在每一个案例中, 比坐着更重要吗, and in many cases was very close to having elevation in both,尤拉舍克说.

研究结果表明，检查仰卧位血压可能会揭示高血压，否则在医生的办公室会被遗漏, 他说. 但 he added that much more research would need to be done first.

Dr. Wanpen Vongpatanasin, a professor of medicine at UT Southwestern Medical Center in Dallas, called the study important but agreed that more research is needed.

先前的研究表明，夜间血压独立地预测心血管疾病的预后, 但目前还不清楚这是否与读数的沙巴足球体育平台有关，还是与被测者的位置有关, 说Vongpatanasin, who is director of UT Southwestern's Hypertension Fellowship Program. She was not involved in the new research.

"This study suggests that supine blood pressure may be one explanation, as it has as much impact on long-term cardiovascular outcome as seated blood pressure,她说.

研究结果强调了控制所有体位血压的重要性, Vongpatanasin说. 但 她说 it is too early to make treatment decisions based on supine readings. 在繁忙的临床实践中，找沙巴足球体育平台增加这样的阅读也有实际的考虑, 她说.

Juraschek承认，这项研究的局限性之一是在最初的测量中, patients had been lying down for about 20 minutes, which is much longer than would happen in a typical doctor's visit.

但, 他说, “我确实认为这是一个足够简单的评估，人们可以自己检查, and people could use it in screening as well."

The study was not designed to look at possible explanations for the differing readings. Juraschek speculated that several factors could be responsible for these findings, 从病人放松躺下时更容易获得准确读数的可能性，到身体平躺时液体在身体周围流动的物理学原理，而不是坐着.

With more studies and more information, 仰卧位血压可以帮助发现那些治疗被推迟的高血压患者，因为他们一直“在雷达下飞行”,他说. It also could identify people who might not need treatment.

但 for now, Juraschek说, monitoring seated blood pressure will remain key. “关于坐式血压的治疗有大量的证据，我们不能忽视."