Some people have inquired about taking blood pressure lying down. Every muscle can be fully relaxed in that position, so why not? In addition, it might make the reading lower. Therefore, let’s answer the question, should blood pressure be taken lying down?
Blood pressure should not be taken lying down. The American Heart Association and the American College of Cardiology recommend taking blood pressure sitting down. Blood pressure should only be measured lying down if a condition makes it too difficult to sit down.
This article will explain every aspect of why lying down should not be your first choice. Although there are times when it’s appropriate. I’ll inform you when and tips on how to perform it correctly.
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Why Blood Pressure Should Not Be Taken Lying Down
In 2017 the new blood pressure guidelines were released by the American College of Cardiology and the American Heart Association. 1.
Their instruction for medical professionals while in the office is to measure blood pressure while the patient is sitting down. The following quote is from step 1: Properly prepare the patient.
Have the patient relax, sitting in a chair (feet on floor, back supported) for >5 min.
The guidelines further state, in regards to the body position.
Measurements made while the patient is sitting or lying on an examining table do not fulfill these criteria.
They state this because the exam table does not provide support for the back or feet.
The next section of the guidelines addresses when a patient will be monitoring blood pressure at home. The guidelines instruct the medical professional how to train the patient for home monitoring. It states the following:
Sit with back straight and supported (on a straight-backed dining chair, for example, rather than a sofa).
In 2019, the American Heart Association published an updated scientific statement regarding the measuring of blood pressure 2. While stating key points for accurately measuring blood pressure, they mention the following:
BP measurement is most commonly made in either the seated or the supine (lying) position. Seated measurements are preferred given the large amount of data correlating BP obtained in this position with outcomes.
In other words, they prefer it’s taken sitting down because most BP measurements are taken that way. The results and comparisons of blood pressure measurements are more consistent over time.
In the body position section (table 4) they report differences in blood pressure measurements between lying and sitting down.
Systolic BP has been reported to be 3-10 mmHg higher in the lying than seated position. Diastolic is 1-5 mmHg higher when measured lying vs seated.
In addition, the updated statement mentions when taking blood pressure lying down, if the arm is resting on the bed, it will be below the level of the heart. When taking BP lying down, the cuffed arm should be supported by a pillow. This brings the cuff higher and level with the heart.
Having the cuff at heart level is mandatory for every body position, including standing up 3. There are many other critical steps which should be followed when taking BP lying down. I wrote a blog post on the topic which you can check out right here, Blood Pressure Lying Down.
When You Should Take Blood Pressure Lying Down
As mentioned earlier, BP should be taken sitting down unless conditions exist which doesn’t make it feasible. Under this situation you’ll have to ask, should I take blood pressure lying down?
Blood pressure should be taken lying down for the following reasons:
- When diagnosing or treating postural hypotension.
- When diagnosing or treating orthostatic hypertension.
- When diagnosing or treating supine hypertension.
- The patient is hospitalized.
- The person is confined to a bed at home.
Postural Hypotension: This occurs when blood pressure is abnormally low when a person stands up from a lying down or sitting position. The decrease may recover closer back to the person’s normal pressure or remain lower. It’s also known as orthostatic hypotension 4.
To help diagnose and treat the condition, blood pressure will be measured while lying down and standing up. Orthostatic Hypotension can be caused by the following:
- Old age
- Prolonged bedrest
- Certain medications
- People who don’t experience a drop in BP when sleeping.
- Supine hypertension
Orthostatic Hypertension: This is the opposite of postural hypotension. This condition is when a person’s blood pressure increases while standing up 5.
This can occur for the following reasons:
- Elderly people
- Type 2 diabetes
- Fluctuations in blood pressure and heart rate.
- An increase in the heart rate and change in blood pressure when standing up.
- When an artery in the back gets compressed.
- Conditions that cause the autonomic nervous system not to work properly.
Supine Hypertension: A condition when someone’s pressure increases while lying down. This can occur while awake or sleeping. A common cause is autonomic failure which is a disease that affects the nervous system that regulates involuntary functions like BP 6.
The Patient is Hospitalized: In a hospital, it’s very possible your blood pressure will be measured while lying down. Depending on your medical condition, during and after surgery are reasons why you may be confined to the bed.
Confined to the bed at home: Your medical condition, injury or recovery may force you to remain in a lying down position while at home.
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Read More BP Related Articles in This Same Website!
- AHA Journals Hypertension: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
- Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
- Journal of Human Hypertension: Both body and arm position significantly influence blood pressure measurement
- Genetics Home Reference: Orthostatic Hypertension
- National Center for Biotechnology Information: Orthostatic hypertension: Recognizing and under appreciated clinical condition
- American Heart Association: Heating pads may lower blood pressure in people with high blood pressure when lying down