Q: In the sitting position my BP is 135/80, lying position it is 117/60. Why the drastic difference? Thank you.
A: The heart is a pump. It takes less effort to pump blood to your brain when you are lying down because your head is about the same level as your heart. When you stand up, your head is much higher than your heart.
The heart has to pump harder to get blood to your brain so blood pressure is higher. It is well known that blood pressure varies with position. This is why blood pressure at the doctor’s office is taken while you are sitting in a chair with your arm at the level of your heart.
(39 votes, average: 3.72 out of 5)
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Gee, I wonder if it matters that when you stand up, versus lay down, although your head is higher, everything below your heart is lower……abdomen, trunk, legs, feet, etc. Seems an interesting tradeoff for the static head facing that “pump”, to me. When you are in the hospital for high blood pressure (been there/done that), your blood pressure is monitored constantly while you are actually laying down in the hospital bed……….hmmm
Respectfully, I think I would look for a better answer as to why your lying versus standing blood pressure seems so significanlty different.
All the best!
Does carrying heavy loads increase blood pressure?
DC is right. Standing bp with arm at heart level will be lower than lying down bp, everything else being equal. No respect intended.
Don’t forget, even though almost everything is below your heart when you are standing, the trip DOWN is only half the journey. The blood must then be pumped back UP the hill. Think this stuff out before challenging the doc, folks!
Maybe we should allow the doc to face up to the challenge. Remember only half of what they learn in med school is right. Which half did they retain?
Having a doctorate in heart mechanics and more than 30 years of heart research, with all due respect to D. Carestia, Dr. Rowena is absolutely correct. If not for the baroreceptor reflex in your carotid arteries, your blood pressure would not rise to normal values when you stand up, and you would feel lightheaded or pass out, frequent in the elderly, orthostasis. When standing, there is a huge difference between pressures in your head and your feet due to this ‘column of water’ or in this case, blood. That’s a simple calculation that Archimedes did a long, long time ago. So, pressure in the head is much lower than pressure in the feet, another reason for swelling or edema down there that is ofen relieved when lying down. In the hospital the physicians and nurses want to have some gauge of your blood pressure. If it is really bad, it will be bad even when lying down, and that’s worth knowing. Cuff pressure is only an approximation of what you would see if you could actually put pressure transducers inside your heart or artery. Hope this helps.
The Mayo Clinic protocol on taking blood pressure: Rest for at least 5 minutes. Take three readings at least 5 minutes apart sitting, with the monitor at the approximate level of the heart. Throw the first reading out. Average the remaining two. That is your best measure of blood pressure on average. An alternative is to get a blood pressure monitor with MAM technology. It takes three separate readings and averages them for you. My favorite is Microlife Premium Advanced Blood pressure monitor.
If you stand quitely and restfully for 5 minutes, your blood pressure will be very different from when you first stand up. Nobody suggests standing up to take your blood pressure, including me. Respectfully, esoteric discussions about head pressures, or static head in various positions don’t help much.
All the best!
And what about different bp within consecutive meditions? Is it possible to get BP x and 1 min. then, in the same position, get another with, lets say, 30% variation?
Actually, your response is NOT very respectful. Dr. Rowena is correct in how hard the heart works in sitting verus lieing positions.
According to Dr Rowena’s logic, presumably the best position for obtaining the lowest blood presure would be by standing on one’s head?
I am finally glad to see the heart called a pump. In every article these “professional” answer their own question about variable blood pressure readings by saying relax for 5 minutes in a comfortable chair,feet on the floor,empty bladder,don’t eat an hour before test…etc.What they are saying is when they finish that is going to be the lowest reading possible for you unless you have white coat syndrome or…etc.There are 398 recognized conditions that causes high blood pressure. Do you need 398 pills or 276 or…etc. Now for the “pump”. The average human has 60,000 miles of blood vessels in there body. Small,big,parallel,series on the surface,deep within the body. Go to a city water engineer and tell him you have 1 pump that will guarantee the same water pressure for every situation he has in his 60,000 miles of water pipes.Be careful or you might end up on a zombie farm.
My attempt is to respond in a proper fashion. JasoMI, Dr. Rowena has had consistently fairly good answers. This time , I’m afraid she left herself open. I agree with D. Cartesia that the Doctor’s response is too ambiguos. In addition to that the blood pressure monitor is not located in your head/brain, but in a very well known area. I think she’s giving too much credit to the effects of gravity. Another reason why a lower reading could be because the person lying down maybe a lot more relaxed than when faced with the white robe syndrome. Do you get my drift? Also, you should relax with your answers here. We’re just concerned people. You might be creating a high blood pressure problem for yourself with that attitude. Good luck !!!
actually d.c. has a very valid point, of you just think about it.
The original question was a good one and deserves a more comprehensive answer. During a 4-day hospital stay, my blood pressure was taken several times each day–always while I was lying in the hospital bed–sometimes propped up on pillows and sometimes lying flat, arm in no particular position. Also, sometimes I was on the telephone talking and occasionally during meal time. there was never a request to change positions or to stop whatever activity I might have been engaged in. The overhead monitor showed the BP reading digitally. Each time, the nurse (or CNA) would do at least two BP readings. After several days of medication, a very high BP reading at hospital admission appeared to be lowered significantly. However, based on Dr. Rowena’s answer, those later “lower” BP readings might be somewhat suspect and possibly not the “true” or “best” BP reading for further treatment decisions. The decision re hospital discharge was related in large part to those “lower” BP readings, which might have been higher had they been taken while I was sitting in a chair with arm at heart level, or at least sitting up on the edge of the bed. Dr. Rowena–any further explanation, please? Or any further explanation from other readers would be appreciated. Thank you.
What really concerns me is that the real blood pressure reading is when you are standing, working, exercising, sitting, etc., meaning “living”. Thus, for me that’s the blood pressure we should be concerned about. In my case it seems I have my blood pressure controlled when lying down but not when I am “living”.
hi,
please why when i take my blood pressure with only 2 minutes apart I have always differents readings,,,example …this morning 131-92…185-78…131-85…with only 2 minutes apart from each other…your friend beatrice
Very valid point indeed….. perhaps the dr. should elaborate on this point??
Very very rare any doctor has a nurse working in his office, they are too expensive. So a
Tech of some kind is taking your bp not a nurse. Sadly everyone assumes they are nurses and the techs do not correct this, and sometimes say they are nurses which is fraud but they do it all the time.
Still don’t know the answer.
The Mayo Clinic protocol on taking blood pressure: Rest for at least 5 minutes. Take three readings at least 5 minutes apart sitting, with the monitor at the approximate level of the heart. Throw the first reading out. Average the remaining two. That is your best measure of blood pressure on average. An alternative is to get a blood pressure monitor with MAM technology. It takes three separate readings and averages them for you. My favorite is Microlife Premium Advanced Blood pressure monitor.
If you stand quitely and restfully for 5 minutes, your blood pressure will be very different from when you first stand up. Nobody suggests standing up to take your blood pressure, including me. Respectfully, esoteric discussions about head pressures, or static head in various positions don’t help much.
All the best!
Whoever got closest to saying that pressure will be measured higher when taken at a lower point relative to the rest of the body (and lower when taken at a higher point) is the most correct.
It’s the same as if you had a 6′ tall pipe full of water, and measured the pressure 6″ from the bottom and 6″ from the top. Near the bottom would be approximately 2.4 psi, while at the top would be approximately .2 psi (2.31 feet of head per 1 psi). It is a physical impossibility for things to be any different in the human body.
As for requiring more pressure to pump uphill than down, no, not true in a closed system. Where the uphill side would require pressure if open, the downhill side negates the uphill side with the same as a siphon effect because there are no air space free fall areas in between. In a similar water pumping system, the only horsepower required would be enough to overcome the friction losses of the pipes and valves. The same holds true for the body.
In case you can’t tell, I’m an engineer, not a doctor. Still yet, there is no valid argument to the contrary of my explanation.
It is *NOT* a physical impossibility for the body to be different that a 6-foot pipe. Arteries and veins dilate and constrict. Pipes do not. Vessels widen and pressure falls, they constrict and pressure increases. There are biochemical processes that manage this vasodilation and vasoconstriction, so there are variables you haven’t considered.
The medical health industry is big business. You aren’t worth much if you can’t be admitted.
How much does low iron levels have to do with blood pressure readings and any lung capacity issues. I have had low iron most of my life and am taking supplements to help with the problem. I have had trouble however with higher blood pressure when sitting up 135/80’s and really low at night while resting or lying down 109/56 etc.
Thank you.
The health tech in the doctor’s office rarely takes blood pressure correctly. Sitting in an uncomfortable position, feet hanging and not touching the ground, arm allowed to hang downward, being a too-cold room, all contribute to blood pressure being incorrect.
So could someone explain this, laying 120/80, sitting 140/100, standing 160/115?
I”m on my 3rd BP medicine now and the only thing its doing is slowing my heartrate down. What causes this much difference?
Thanks
Steve, it sounds like you have Hyperadernergic POTS
Google it