The other day I was thinking the same thing, I was wondering why we don't wear our tanks valve downward. I can see how on a boat it could be problematic with all the tanks in a row, etc. And of course you would need some kind of stand to be able to put the bc on the tank in the first place, which would be a PITA
The only other real advantage I could see, aside from possibly the valve being safer in an overhead enviroment, though actually the way the valves turn this would be a disadvantage since you could roll closed the valve if you didn't change the orientation, is that it might make it slightly easier to reach the 1st stage with it downward, but this is easily corrected with some good stretching and exercises.
Mostly I wonder if the reason we keep the tanks the way we do is that is how it has been done, and thus that is how we all learn it and keep doing it. It might be fun to try this out one of these days, get longer hoses and see how the routing would work... hmm something to do something to do ...