Rise in blood pressure upon standing linked to risk for heart attack, stroke

If your blood pressure spikes when you stand, you may be at increased risk for heart attack and stroke, Italian researchers warn.

"The results of the study confirmed our initial hypothesis -- a pronounced increase in blood pressure from lying to standing could be prognostically important in young people with high blood pressure," said lead study author Dr. Paolo Palatini. He is a professor of internal medicine at the University of Padova, in Italy. 

"We were rather surprised that even a relatively small increase in standing blood pressure (6 to 7 mm Hg) was predictive of major cardiac events in the long run," Palatini added.

The new study included more than 1,200 Italian adults, aged 18 to 45, with untreated stage 1 high blood pressure, defined as systolic blood pressure of 140 to 159 mm Hg and/or diastolic blood pressure of 90 to 100 mm Hg. (Systolic blood pressure is the force exerted on blood vessels when the heart beats a diastolic reading measures pressure between beats.) 

None of the participants had taken blood pressure-lowering medication prior to the study, and all were initially judged to be at low risk for major heart events based on their lifestyle and medical history -- no diabetes, kidney impairment or heart disease.  

At the outset, blood pressure readings were taken with participants in various physical positions, including lying down and after standing up.

Among the participants with the highest rise in blood pressure upon standing, the top 10% averaged an 11.4 mm Hg increase in blood pressure all were greater than 6.5 mm Hg. The other participants averaged a 3.8 mm Hg drop in systolic pressure upon standing. 

During an average 17-year follow-up, study participants experienced 105 major heart-related events, with the most common being heart attack, heart-related chest pain and stroke.

Odds of a major heart event were almost double for people in the top 10% group, the investigators found.

After adjusting for average blood pressure taken over 24 hours, the researchers concluded that a large increase in blood pressure upon standing remained a predictor of heart attack, stroke and other major cardiovascular events

The study suggests the need for tailored interventions, Palatini said.

"The findings suggest that blood pressure upon standing should be measured in order to tailor treatment for patients with high blood pressure, and potentially, a more aggressive approach to lifestyle changes and blood pressure-lowering therapy may be considered for people with an elevated [hyperreactor] blood pressure response to standing," he said in a journal news release. 

 

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Heart disease greater in people living near oil & gas wells

People living near areas with oil and gas exploration sites could be at more risk of developing cardiovascular disease, say researchers. The pilot study found that those who lived in these areas showed early signs of CVD, including higher blood pressure, changes in the stiffness of blood vessels, and markers of inflammation.

"We are not sure whether the responsible factor is noise or emissions from the well pads or something else, but we did observe that with more intense oil and gas activity around a person's home, cardiovascular disease indicator levels increased," said a researcher.

For the study, the team measured indicators of CVD among nearly 100 men and women. These participants did not smoke tobacco or marijuana and had no history of diabetes, chronic obstructive pulmonary disease or chronic inflammatory disease like asthma or arthritis. 

Also, the participants did not have jobs that exposed them to dust, fumes, solvents or oil or gas development activities. While behavioural and genetic factors contribute to the burden of CVD, exposure to environmental stressors, such as air pollution, noise and psychosocial stress also contribute to cardiovascular morbidity and mortality.

One increasingly common source of these stressors is extraction of oil and gas in residential areas, which includes fracking, horizontal drilling, and micro-seismic imaging, the researchers said.

In addition, previous studies have shown that short and long-term exposure to the kind of particulate matter emitted from oil and gas operations may be associated with increases in CVD and death.

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