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Pulse Pressure?


mkoven
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I've been recording my sitting and standing bp in the morning for my ans doc. i don't wait before measuring the standing, in part to save time, in part to avoid making myself too sick early in the day. so it's a rough measure of how I'm doing.

Usually my bp drops some when I stand. Today, the bottom number rose quite a bit, while the top stayed the same:

sitting 108/67, standing 108/90

I felt pretty bad standing, and if you'd asked me, I would have guessed it was lower, not higher. My vision started dimming and i felt kind of twitchy/swaying.

So does the diastolic rise just mean a narrowing of pulse pressure, which explains why I felt bad?

I can never tell whether my bp is going up or down-- just that I feel bad!

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A rise in diastolic BP on standing usually corresponds to the blood vessels contracting to prevent blood pooling. This would normally mean that you should feel better (but we all know that our bodies numbers often don't match how ill we actually feel). A pulse pressure of 18mmHg (difference between systolic and diastolic pressures) should be enough to keep you feeling ok. I know that when my pulse pressure has been only 6mmHg (BP 96/90) I have almost passed out as there is virtually no forwards blood flow in the vessels.

Flop

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My pulse doesn't change much at all. I occasionally get some tachycardia on standing, but the big shifts for me are mostly in blood pressure, and usually pretty soon after standing--which is my my diagnosis has been ncs rather than pots. But my new ans doc just prefers the term autonomic dysfunction.

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