Aim- To study effect of posture

on arterial blood pressure.

• Apparatus: Stethoscope, Sphygmomanometer
• Procedure:
1. Ask the subject to lie on supine on couch for 5-
10 min. Do not untie the cuff.
2. Ask the subject to sit up and immediately note
the BP.
3. Similarly make the subject stand from lying
down position and repeat whole procedure.
4. Compare the BP reading in different posture.
Precautions:
1. BP should be recorded by keeping BP
apparatus at the level of heart in all position.
2. Since, changes in the BP are sudden and of
short duration . Therefore BP should be
recorded to 30-60 sec in change of position.
3. Donot untie the cuff in between the change
in position.
Discussion:
1. During lying down position, effect of gravity is notified and
venous return increases which leads to increase in cardiac
output and thus increase in systolic BP.
2. On sudden standing, there occurs peripheral pooling of blood
in dependent parts which causes decrease in venous return
thereby cardiac output decreases, so systolic BP falls by 10-
15mm Hg.
This reflex via a baroreceptor discharge, increases DBP. Thus
upon sudden standing from lying/supine position, increases
DBP.
However, it will return back to normal level after 1-2 min due
to operation of baro receptor reflex.
The effect of change in posture
• It depends upon whether these are recorded
immediately after standing from supine
position, or after prolonged standing. They
also depend on whether a person stands
against a support (e.g. a wall), or is standing
free and still.
Immediate effect
• As the person assumes erect position, blood
tends to pool in the lower parts of
body( especially in veins) due to gravity. This
decreases cardiac output and BP. A pooling of
250 – 300 ml of blood can decrease SBP by 10-
15 mm Hg. However, within 8-10 sec the sino-
aortic baro receptor mechanism restores BP to
normal level.
Effect of prolonged standing
• If a person stands, especially against a support,
more than 500 ml of blood may pool in the lower
body. Also increased capillary hydrostatic pressure
causes fluid to be filtered out in the tissues, further
decreases venous return.
• The cardiac output and BP falls leading to cerebral
ischaemia that causes the person to fall down
unconscious.The fainting is actually a homeostatic
mechanism,as it restores venous return, CO and BP,
thus relieving cerebral ischaemia.
Observations:
Systolic BP Diastolic BP
1. Sitting Normal Normal
2. Lying down Increase Decrease
3. Standing Decrease Increase

Posture Systolic BP(mm Hg) Diastolic BP(mm Hg)

1. Lying down 130 70
Standing 110 90
2. Lying down 130 70

Sitting 120 80