AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Elevated Supine Blood Pressure in Younger Adults with Normal Sitting Blood Pressure Might Be Still Associated with Structural and Functional Abnormalities
By ElShahawy M, Spahiu M, Sabatini A
Background: Cardiovascular risk assessment in young adults as performed in the CARDIA trial was based on seated blood pressure measurements. Purpose: The purpose of this study is to assess the prevalence of CV structural and functional abnormalities in young adults below 45 years with normal sitting but abnormal supine BP. Methods: A total of 3017 asymptomatic subjects were screened for cardiovascular risk utilizing the Early Cardiovascular Disease Risk Scoring System (ECVDRS), also known as Rasmussen Risk Score, which has been previously published. This scoring system in summary consists of 10 CV tests: 7 vascular tests and 3 cardiac tests. Among these tests, the protocol BP exercise stress test consists of 3 minutes walk at 2.3 mph and 7% elevation. This test has been established to be considered abnormal if BP rise post protocol exercise is > 30 mmHg. 276 subjects less than 45 years old out of the 3017 were not taking any CV medication, were the subjects of the study. BP measurements were taken in sitting, supine, standing and post protocol exercise. Results: Are shown in Table. 1. 9% of subjects under 45 were found to have elevated supine blood pressure despite normal seated blood pressure. 2. Subjects with normal seated blood pressure and elevated supine blood pressure showed increased abnormal BP rise post protocol exercise in 35% and abnormal C2 in 24% of subjects, respectively. Conclusion: Structural and functional abnormalities might be present in young subjects with normal sitting but abnormal supine BP. Therefore, it's time to mandate early screening with supine and post exercise blood pressure measurements even in younger age groups. Early detect to protect.