Netea R T, Smits P, Lenders J W, Thien T
Department of Internal Medicine, University Hospital Nijmegen, The Netherlands.
J Hypertens. 1998 Mar;16(3):263-8. doi: 10.1097/00004872-199816030-00002.
Several guidelines for the management of hypertension do not give special preference to a specific position of the patient during blood pressure measurement, suggesting that blood pressure readings taken with patients sitting and with patients supine are interchangeable.
To test whether there is any difference between the blood pressure readings with patients sitting and supine.
Blood pressure and heart rate were measured three times each for 245 subjects (171 hypertensives), with subjects both sitting and supine, simultaneously on both arms, with a Hawksley random-zero sphygmomanometer on the right arm and a semi-automatic oscillometric device (Bosomat) on the left arm. The sequence of the two positions was randomized. The procedure was repeated on a second occasion for 49 subjects (41 hypertensives) with the sequence of the positions reversed. Because there was no systematic difference among the three readings per position, the averages of the three blood pressure and heart rate readings with subjects sitting and supine were compared and the influences of age, body mass index, hypertension and medication on the difference were examined.
We found no influence of the subject's body posture on the systolic blood pressure. We found a higher diastolic blood pressure [by 5.2+/-0.4 mmHg (mean+/-SEM), P< 0.001 with Hawksley random-zero sphygmomanometer] and a greater heart rate [by 1.5+/-0.3 beats/min (mean+/-SEM), P< 0.001] with subjects sitting. The sitting minus supine differences for diastolic blood pressure and heart rate decreased significantly with increasing age (P< 0.001). We found no effect of body mass index, hypertension and medication on the sitting - supine differences.
The subject's body posture influenced especially the diastolic blood pressure and heart rate, both of them being significantly higher with patients sitting rather than supine. This effect decreased with age. Thus, for indirect blood pressure measurement, diastolic blood pressure values obtained with subjects sitting and supine cannot automatically be regarded as equivalent.
多项高血压管理指南在血压测量时未对患者的特定姿势给予特别偏好，这表明患者坐着和仰卧时测得的血压读数可相互替换。
测试患者坐着和仰卧时的血压读数是否存在差异。
对245名受试者（171名高血压患者）的血压和心率分别进行三次测量，测量时受试者分别处于坐姿和仰卧姿势，同时测量双臂血压，右臂使用Hawksley随机零点血压计，左臂使用半自动示波装置（Bosomat）。两种姿势的测量顺序随机安排。49名受试者（41名高血压患者）以相反的姿势顺序在第二次测量时重复该过程。由于每个姿势的三次读数之间没有系统差异，因此比较了受试者坐姿和仰卧时三次血压和心率读数的平均值，并研究了年龄、体重指数、高血压和药物治疗对差异的影响。
我们发现受试者的身体姿势对收缩压没有影响。我们发现，受试者坐着时舒张压更高[使用Hawksley随机零点血压计时高5.2±0.4 mmHg（平均值±标准误），P<0.001]，心率更快[快1.5±0.3次/分钟（平均值±标准误），P<0.001]。随着年龄的增加，舒张压和心率的坐姿减去仰卧姿势的差异显著减小（P<0.001）。我们发现体重指数、高血压和药物治疗对坐姿与仰卧姿势的差异没有影响。
受试者的身体姿势尤其影响舒张压和心率，两者在患者坐着时均显著高于仰卧时。这种影响随着年龄的增长而减小。因此，对于间接血压测量，不能自动认为受试者坐着和仰卧时获得的舒张压值是等效的。
