Influence of different supine body positions on blood pressure: consequences for night blood pressure/dipper-status.

Abstract

To investigate the influence of different supine body positions on blood pressure measured by an ambulatory device. Twenty hypertensive and 20 normotensive subjects of a tertiary hospital outpatient clinic participated. Blood pressure was measured with an ambulatory blood pressure device while lying in the back, left side, right side and abdominal positions. The distance between the antecubital fossa and sternum was measured in all four body positions. An expected blood pressure difference between the arm of measurement and the right atrium (i.e. the midsternum) was calculated for the different body positions. When blood pressure was measured in side position at the left arm in hypertensive subjects, the mean systolic and diastolic blood pressure differences (+/- SD) between the left arm in the lower position and in back position at the same arm were +5/+4 (8/6) mmHg. These differences were -14/-17 (6/4) mmHg for the left arm lying above heart level in side position. Values of the right arm in hypertensives and the measurement at both arms in normotensive subjects yielded similar differences. Body and arm position can both significantly influence the ambulatory blood pressure and therefore the day-night difference. This comprises one of the main reasons for the moderate individual reproducibility of the blood pressure fall at night.