Pressure difference between Supine and Sitting

65/F Moderate to severe Headache and Dizziness since morning No H/O - Pain abdomen, Retrosternal burn, Fullness of abdomen H/O - Patient is on Amlodipine 5mg O/E : BP :- At 9.30 AM = 200/104 (Supine) At 11.00 AM = 170/80 (Supine BP 1 HR after inj lasix, Headache reduced) At 11.45 AM = 160/84 (Supine) but 138/76 (Sitting) , Symptoms releived. Questions : 1. What are the causes of difference between this supine and sitting BP ? 2. What should be done next ? 3. Should the pressure medicine be changed ?



Which ever is higher should be considered as any point of time heart has to pump @ that pressure.. But to start antihypertensive drug series of measurement in sitting and supine position.dd diuretic at low doses.

The blood pressure tended to drop in the standing position compared with the sitting, supine and supine with crossed legs. Systolic and diastolic blood pressure was the highest in supine position when compared the other positions.

Never start hypertensive medicine in supine It must be on prone or standing Add diuretic Change of supine to prone to Diastolic more then15 is hypotensive Change the drug

Manage blood pressure under normal limits Change medicine

Thank you doctor

Lasic is not use as antihypertensive medicine Must visit physician with adequate experience with hypertension management Get cardiac evaluation

Mange B P strictly

Patient has wide pulse pressure when supine, and raise in systolic bp. Go for echo to r/o valve prolapse, regurgitation and Dcmp.

SUPINE AND SITTING Has one common feature low bp than STANDING , Standing pull down blood flow due to gravity so less blood to brain cause HR increase and Bp increases..... Systolic almost more than 160 Please add combination of 2 drugs such Ca channels blockers + ARB or ACEI or Diuretic *CCB+ARB (best combination).... Phase 2 HTN medication ..... Check For Lipid profile...

Monitor BP on regular intervals mostly with supine/sitting position only.. Put patient on ARBs and diuretic.. eg. Telmisartan40mg with hydrochlorothiazide12.5mg u can add instead of amlodipine5mg.. Restrict salt as much as possible.. Manage stress levels..

Sir pt age more than 65 most preferably drug are CCB instead of ARB

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