Higher blood pressure when standing up may be linked with increased heart attack risk

Photo (c) Jose Luis Pelaez Inc - Getty Images

Experts say taking standing blood pressure readings for younger consumers may help identify those with higher risk of complications

While recent studies have found that blood pressure readings may vary depending on where they’re taken, a new study conducted by researchers from the American Heart Association focused on the risks associated with higher blood pressure when consumers stand up. 

According to their findings, consumers who experience a spike in blood pressure when they go from sitting to standing may have a higher risk of having a heart attack. 

“This finding may warrant starting blood pressure-lowering treatment including medicines earlier in patients with exaggerated blood pressure response to standing,” said researcher Dr. Paolo Palatini. 

Long-term heart attack risk

For the study, the researchers analyzed data from over 1,200 people enrolled in the HARVEST study. This Italy-based dataset started in 1990, and collected information on adults between 18 and 45 who were diagnosed with – but not being treated for – stage 1 hypertension. All of the participants had their blood pressure taken in six positions lying down and six positions standing up. The team then followed their health outcomes over the course of nearly 20 years. 

The researchers found an interesting relationship between blood pressure upon standing and the risk of a heart attack. The study identified a group of participants who experienced a significant increase in systolic blood pressure upon standing; on average, blood pressure shot up 11.4 mm Hg. Participants in this group were nearly twice as likely to have a heart attack despite showing no other cardiovascular-related health concerns at the start of the study. 

“The results of the study confirmed our initial hypothesis – a pronounced increase in blood pressure from lying to standing could be prognostically important in young people with high blood pressure,” Dr. Palatini said. “We were rather surprised that even a relatively small increase in standing blood pressure (6-7 mm Hg) was predictive of major cardiac events in the long run.” 

Aside from this pattern with standing blood pressure, the researchers found that participants in this group showed favorable health outcomes. They had better cholesterol levels than other study participants, exhibited comparable physical activity levels, had no family history of cardiovascular issues, and had healthy BMIs. 

However, the study showed that these participants were more likely to be smokers than those without this sharp uptick in blood pressure upon standing. This group also had higher overall blood pressure readings over the course of 24 hours. 

The researchers hope these findings identify patients who may have a higher risk of serious heart health issues – particularly those who are younger and may not present with any other major cardiovascular risks. 

“The findings suggest that blood pressure upon standing should be measured in order to tailor treatment for patients with high blood pressure, and potentially, a more aggressive approach to lifestyle changes and blood-pressure-lowering therapy may be considered for people with an elevated [hyperreactor] blood pressure response to standing,” Dr. Palatini said. 

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