Supine blood pressure measurement and its emerging role in cardiovascular risk stratification.

The measurement of an individual's blood pressure (BP) while he or she is in a seated position is the standard BP measurement method. The significance of BP measurements obtained from an individual while he or she is in the supine position has also been described. Supine BP values are usually lower than seated BP values, and thus the condition of high supine BP is abnormal and called 'supine hypertension.' Although the mechanisms that underlie supine hypertension are not completely understood, it has been speculated that fluid retention and abnormal sympathetic nervous activity can lead to supine hypertension. Hypertension-mediated organ damage and cardiovascular events have been shown to be associated with supine hypertension; not only supine hypertension with neurogenic orthostatic hypotension but also supine hypertension without it. The treatment of supine hypertension has not been established. Considering the pathophysiological background of this condition, the use of antihypertensive drugs and bedtime dosing may be effective. Further research is necessary to clarify the significance of supine hypertension and to establish the optimal treatment for this condition.