A new study has found that young and middle-aged adults with high blood pressure who experience a spike in their blood pressure when they stand up may face a greater risk of serious heart problems in the future.
These include heart attacks, strokes, and other major cardiovascular events. The study was published in the journal Hypertension, by the American Heart Association.
Normally, blood pressure drops slightly when a person stands.
But for some people, it rises instead. This unusual response may be an early warning sign that their body is under stress and that their heart health could suffer in the long term.
Dr. Paolo Palatini, the lead researcher from the University of Padova in Italy, says this finding could change how doctors treat patients with high blood pressure. He believes that people who show a big jump in blood pressure when standing might need to start treatment earlier to lower their risk of heart problems.
The study looked at 1,207 adults between the ages of 18 and 45 who had stage 1 high blood pressure but had never taken medication for it. These people were part of the HARVEST study, which began in Italy in 1990.
All participants were considered low-risk based on their medical history and lifestyle. At the time they joined the study, they were an average age of 33, and most were men.
Researchers measured each person’s blood pressure multiple times—when lying down and when standing. The top 10% of participants with the highest rise in systolic blood pressure after standing showed an average increase of 11.4 mm Hg. In contrast, the rest of the participants actually had a small drop in blood pressure when standing.
Over the next 17 years, 105 people in the study had a major heart-related event like a heart attack or stroke. People in the group with the large increase in standing blood pressure were almost twice as likely to have one of these events compared to others in the study.
Interestingly, these people did not appear to be at higher risk during the initial health checks. They were not more overweight, not less active, and did not have worse cholesterol levels. In fact, their cholesterol levels were actually better in some cases.
Their blood pressure while lying down was also slightly lower. But when monitored over a full 24 hours, their blood pressure was higher overall.
Another interesting finding came from a smaller group of participants who had their stress hormone levels measured. Those with a bigger rise in blood pressure when standing had higher levels of epinephrine, a hormone linked to the body’s stress response.
This suggests that their bodies may be more sensitive to stress, which could raise blood pressure over time.
The researchers say this simple test—measuring blood pressure when someone stands—could help doctors better identify who needs more aggressive treatment. It may help prevent serious heart problems in the future by catching risks earlier.
However, the study had limitations. All participants were white, so the findings may not apply to people from other backgrounds. Also, most were men, so it’s unclear if the same results would be seen in women. The number of heart events in the study was also relatively small, so larger studies are needed to confirm the results.
In summary, the study suggests that a rise in blood pressure when standing could be a hidden sign of future heart risk in young people with high blood pressure. Doctors may need to watch for this sign and treat it more seriously.
The study is published in Hypertension.
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