title: The diagnostic value of supine blood pressure in hypertension.
abstract: BACKGROUND
  Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension.
  
  
  METHODS
  This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring.
  
  
  RESULTS
  The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p < 0.000001). The correlations between ABP and supBP/OBP were moderate and strong (correlation coefficients in range 0.55-0.76). The ROC analysis revealed that mean supBP ≥ 130/80 mm Hg was more precise than OBP ≥ 140/90 mm Hg in diagnosing hypertension (AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p < 0.0001) and the additive value derived mostly from its higher predictive power of identifying patients with increased night-time BP.
  
  
  CONCLUSIONS
  In young and middle-aged hypertensive patients the blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension.
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Krzesiński
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Stańczyk
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Gielerak
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Piotrowicz
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Banak
authors.affiliation: Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wójcik
keywords: ambulatory blood pressure monitoring; body position; impedance cardiography; office blood pressure