Heating pads may lower blood pressure in people with high blood pressure when lying down
- In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.
- Heat therapy may be an innovative, non-pharmacologic approach to treat the overnight high blood pressure in these patients.
NEW ORLEANS — Applying a heating pad overnight may help people with supine hypertension, a condition that causes their blood pressure to increase when they lie down including during sleep, according to preliminary results presented at the American Heart Association’s Hypertension 2019 Scientific Sessions.
Supine hypertension is present in about half of people with autonomic failure, a chronic degenerative disease that affects the part of the nervous system that regulates involuntary functions such as blood pressure and heart rate. Overnight increases in blood pressure are associated with damage to the heart and kidneys. It can also increase urine production, which can worsen a condition where a person’s blood pressure rapidly drops upon standing, such as when first getting out of bed in the morning.
Researchers studied 10 patients with autonomic failure and supine hypertension. The average age of the study participants was 76 years, with a systolic (upper number) blood pressure of 168 mm Hg measured in the lying position. During the two-night study, participants received heat at 100 degrees Fahrenheit from a medical grade heating pad placed under their torso on one night, and an unheated pad on the other. Supine blood pressure was monitored every two hours from 8 p.m. to 8 a.m., and heat therapy was applied from 10 p.m. to 6 a.m.
The researchers found that heat therapy applied during sleep decreased systolic blood pressure, with a maximum reduction of 30 mm Hg after four hours of heat. Despite lowering overnight systolic blood pressure, heat therapy did not decrease nighttime urine production or improve the sudden drop in morning blood pressure.
“In many patients with autonomic failure, heat exposure decreases blood pressure by shifting blood to skin vessels,” said Luis E. Okamoto, M.D., study author and research assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. “The use of local, controlled heat therapy may be a novel and simple approach to treat supine hypertension in these patients without using medications; however, additional studies are needed to assess the long-term safety and efficacy of this approach.”
Among the study’s limitations are its small size and its focus on primary forms of autonomic failure, which is a rare condition. Although the study population was Caucasian, the researchers anticipate that the results may be applicable to other ethnic groups.
Co-authors are Jorge E. Celedonio, M.D.; Emily C. Smith, M.P.H., B.S.N., R.N.; Alfredo Gamboa, M.D.; Cyndya A. Shibao, M.D.; Andre Diedrich, M.D., Ph.D.; Sachin Paranjape, M.S.; Bonnie K. Black, R.N., N.P.; James A. Muldowney III, M.D.; Amanda C. Peltier, M.D.; Ralf Habermann, M.D.; Craig G. Crandall, Ph.D.; and Italo Biaggioni, M.D. Author disclosures are in the abstract.
The National Institutes of Health funded this study.
Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect Association policy or position. The Association makes no representation or warranty as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.
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