HypertensionCohort study
Supine Blood Pressure and Risk of Cardiovascular Disease and Mortality
- Prospective cohort study
- Atherosclerosis Risk in Communities (ARIC) study
- 4 US communities
Authors' conclusion
Supine hypertension regardless of seated hypertension had a higher HR for CVD risk than seated hypertension alone.
Study context
- Population
- Middle-aged adults without known cardiovascular disease (CVD) (coronary heart disease (CHD), HF or stroke excluded), ARIC, 4 US communitieswithout known CVD
- Participants
- 11,369 adults
- Exposure
- Supine hypertension vs No supine hypertension
- Outcome
- Incident CHD, HF, stroke, fatal CHD and all-cause mortality
- Follow-up
- Surveillance over 27 years
Main finding
As reported in the abstract
Supine hypertension and CVD outcomes (adjusted Cox models)
Supine hypertension vs No supine hypertensionHazard ratio (95% CI)
incident CHD; median follow-up 25.7 years
1.60(1.45–1.76)
HF; median follow-up 26.9 years
1.83(1.68–2.01)
stroke; median follow-up 27.6 years
1.86(1.63–2.13)
fatal CHD; median follow-up 28.3 years
2.18(1.84–2.59)
all-cause mortality; median follow-up 28.3 years
1.43(1.35–1.52)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Seated hypertension alone vs supine hypertension alone — Seated hypertension alone vs Supine hypertension alone · CHD | 0.72 (0.61–0.85) | |
| Seated hypertension alone vs supine hypertension alone — Seated hypertension alone vs Supine hypertension alone · HF | 0.72 (0.60–0.85) | |
| Seated hypertension alone vs supine hypertension alone — Seated hypertension alone vs Supine hypertension alone · stroke | 0.66 (0.51–0.86) | |
| Seated hypertension alone vs supine hypertension alone — Seated hypertension alone vs Supine hypertension alone · all-cause mortality | 0.83 (0.74–0.92) | |
| 0.512Hazard ratio (log scale) |
Prevalence of supine hypertension, by seated hypertension
- Without seated hypertension
- 16.4% (95% CI, 15.5%-17.2%)
- With seated hypertension
- 73.5% (95% CI, 72.2%-74.8%)
Seated hypertension alone vs supine hypertension alone
- Supine hypertension alone similar to hypertension in both positions; greater than seated alone except fatal CHD
Original publication
Supine Blood Pressure and Risk of Cardiovascular Disease and Mortality. JAMA Cardiol. Published 1 March 2025. doi:10.1001/jamacardio.2024.5213
Summarised from the published abstract; every number is checked against it