New UTSW study says it may be better to check your blood pressure standing up

The CDC estimates nearly half of adults have hypertension. High blood pressure puts you at risk for heart disease and stroke, which are leading causes of death in the U-S and Texas.

You usually sit down to check your blood pressure. But a new study from UT Southwestern Medical Center says standing up may give more accurate results.

KERA’s Sam Baker explored why with study co-authorDr. Wanpen Vongpatanasin, a Professor of Internal Medicine at UT Southwestern Medical Center and Director of its Hypertension Section in the Division of Cardiology.

We looked up the accuracy of seated blood pressure measurements from clinical studies over the years. It showed that the ability to pick up hypertension from seated blood pressure across all the studies was only 50%. Not great.

So since hypertension is so prevalent, affecting almost half of the U.S. population, we thought that there should be a better way of telling who might have high blood pressure in the office, in a practical way, of course.

So, the guidelines now say the way to diagnose high blood pressure should be done outside the doctor’s office because a lot of factors in that setting can affect the results, like workload, stress and not resting properly.

However, the guidelines also recommend validation should be done through a 24-hour blood pressure. The patient is actually walking, standing, walking, not just sitting down cause no one’s sitting down all the time.

So, we’re thinking that perhaps if we are able to capture standing blood pressure, it might be more reflective of the activity the patient is doing outside the office.

Are we at the point where doctors should make that change?

Perhaps more studies will still need to be done. We’re doing a study on people young to middle-aged. We don’t have a lot of older adults, but at least we believe that our data fairly suggests that we should try to do more standing blood pressure, particularly in the people who have blood pressure on the fence on borderline high in the office. Taking another reading standing up might give more data if the patient may have high blood pressure.

Are there signals that individuals should look for as a sign of hypertension? 

They might have headaches, they might have shortness of breath or heart palpitations, but unfortunately, in many cases, hypertension is a silent killer. We’re not aware that they have high blood pressure. Oftentimes, we saw two or more than two. Often the first time they came to the hospital with kidney failure or heart failure. And so I think that, yes, there might be some symptoms, but I think the majority of the time could be very, very silent and to very late.

So that said, what’s the best way to avoid or lessen the chance of hypertension?

Get a good high blood pressure marker and try to measure it at least a few times after resting. And if it’s normal, then I think it’s probably okay, maybe every two or three months or every six months.

But if it starts to be high, one should think about reaching out to the primary care physician and starting a treatment which often starts with a healthy lifestyle:

• Cut down your sodium intake.
• Let’s try to cook a nutritious meal.
• Regular exercise, at least 150 minutes a week of moderate intensity.

No matter whether you end up needing medication or not, leading a healthy lifestyle and regular monitoring of blood pressure would be helpful.

RESOURCES:

UTSW Study: Utility of standing office blood pressure in detecting hypertension in healthy adults

Hypertension

Facts About Hypertension in the United States