Change in supine-to-standing SBP predicts mortality in females

In healthy females, the change in supine-to-standing systolic blood pressure (SBP) is associated with mortality, regardless of traditional risk factors and antihypertensive medications, suggests a study.

“Sex-related discrepancies in mortality risk may be better elucidated and have greater clinical utility if body position and positional changes are considered,” the authors said.

A total of 2,121 apparently healthy males (51 percent) and females (49 percent) with no known disease from the Ball State Adult Fitness Longitudinal Lifestyle Study cohort were included in the analysis.

The authors obtained the resting supine and standing BP of the participants and calculated the supine-to-standing BP change. They then examined the relationship between positional BP and all-cause mortality using Kaplan‒Meier survival curves and Cox proportional hazard models, with adjustments for traditional risk factors and antihypertensive medications.

In unadjusted models, supine and standing SBP and pulse pressure (PP) in males and females, as well as supine diastolic (D)BP, significantly correlated with mortality (p<0.05). In fully adjusted models, supine-to-standing SBP change predicted mortality in females, but not in males. However, supine-to-standing DBP change predicted mortality in males in the unadjusted models only (p<0.05).

The high tertile for change in supine-to-standing SBP (p<0.05) and PP (p=0.059), compared with the low and medium tertiles, had the lowest survival probability in females and the lowest survival chance for DBP change in males (p≤0.05).

“Sex-specific differences in positional BP may provide additional diagnostic insight on all-cause mortality risk,” the authors said.