Blood Pressure Changes in the Leg on Standing

Normotensive and hypertensive patients develop peripheral arterial disease. The authors hypothesized that significant changes in lower extremity blood pressures occur upon standing, which could play a role in the pathogenesis of peripheral arterial disease. Forty-one subjects had blood pressure measurements performed in the arm and ankle in the supine and standing positions. The data show a marked increase in leg blood pressure on assuming the standing position, with mean increases of 65 mm Hg in systolic and 62 mm Hg in diastolic blood pressure in the lower extremities, compared with the arm on standing. In addition, the changes in diastolic pressure in the leg on standing were significantly correlated to height (r=0.47; p<0.002). These data reveal a previously unappreciated aspect of blood pressure, namely a large increase in lower extremity blood pressure values on standing, which may predispose to peripheral arterial disease.