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Study shows heat therapy helps ease supine hypertension

Sep. 19, 2019, 9:32 AM


by Matt Batcheldor

Heat therapy has been shown to lower high blood pressure in patients with a rare condition called supine hypertension, or elevated blood pressure when lying down, according to preliminary results of a Vanderbilt study.

The results, presented at the American Heart Association’s Hypertension Scientific Sessions 2019 in New Orleans, suggest that applying heat may supplant the need to take medication for this particular condition.

Italo Biaggioni

Supine hypertension affects patients 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. This condition is somewhat rare, but more common in patients with Parkinson’s disease, said Italo Biaggioni, MD, professor of Medicine and an author of the study.

Because people with the disorder can’t regulate their blood pressure, they are at risk of low blood pressure when standing and high blood pressure when lying down. Over time, overnight increases in blood pressure are associated with damage to the heart and kidneys.

The Vanderbilt researchers monitored 10 patients with autonomic failure and supine hypertension in an overnight study. While the patients were lying down, researchers measured their blood pressure every two hours from 8 p.m. to 8 a.m. The researchers applied a temperature of 100 Fahrenheit from a medical-grade heating appliance from 10 p.m. to 6 a.m. They found that systolic blood pressure significantly decreased — a maximum reduction of 30±6 mmHg with four hours of heat.

Luis Okamoto, MD

“With this simple technique, we can lower blood pressure acutely, we can program it to turn off before they wake up, and when they wake up, they are back to baseline,” Biaggioni said. “We can control this without medications.”

“In many patients with autonomic failure, heat exposure decreases blood pressure by shifting blood to skin vessels,” said Luis Okamoto, MD, another study author and research assistant professor of Medicine. “The use of local controlled heat therapy may be a novel and simple approach to treat supine hypertension in these patients without using drugs, but future studies are needed to assess the long-term safety of this approach.”

Biaggioni said the researchers hope to translate the research into a targeted heat therapy that patients can use.

The study’s other co-authors are Jorge Celedonio, MD; Emily Smith, MPH, RN; Alfredo Gamboa, MD; Cyndya Shibao, MD; Andre Diedrich, MD, PhD; Sachin Paranjape, MS; Bonnie Black, RN, NP; James Muldowney III, MD; Amanda Peltier, MD; Ralf Habermann, MD; and Craig Crandall, PhD.

Funding for the study came from the National Institutes of Health.

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