High Blood Pressure When Feeling The Worst?

[Nikki]

My cardiologist said as a good exercise to kind of 'train' my body is to just stand up against a wall for 10 or 15 minutes or so, and to keep track of my blood pressure and heart rate to see how it changes. Well, I tried that today and was only standing for 4 minutes before I almost passed out. When I first started standing my blood pressure was 104/73. Four minutes pass and I get super dizzy so I quick sat down on the floor and then laid down when just sitting didn't help. I took my blood pressure when I was laying down and it went up to 152/107. I'm just a bit confused because I thought when you feel like passing out, it's because your blood pressure is too low? My blood pressure normally runs low, but seems to shoot up when I'm on the verge of passing out.

Does anyone else get like this?

[potsgirl]

I'm sure there are others out there like you, but I usually pass out or feel like I'm going to when my BP gets too low. I'm not familiar with the scenario where you feel like passing out when your BP gets too high....Ask your doc.

[janiedelite]

My BP goes up when I talk, stand, or do much of anything. It really never drops except the first minute I stand. When it goes up, I have all the pre-syncopal symptoms including black spots in vision, nausea, headache, etc. Mayo said my norepinephrine level goes up to much when I stand in an attempt to increase blood flow to my brain.

However, when I lie down my BP usually normalizes within a few minutes.

[tinkerbella]

You sound a lot like me. This is what I'm going through and now I have paradoxal hypertension as well as pots. That's what the doctor called it on Thursday and said he had only seen it in one other pt before. My botton number keeps getting higher and higher in each position. Yesterday my bp pressure was getting really high from sitting. 149 /100 and my case worker was here with me helping me.

Thankfully she made me lay down and my bp came down a bit and then spiked up to 168/102 and then I stood and I couldn't get it to budge but my heart rate I brought down with meds 20 points standing. It was scarey, usually I always have a headache strange that I didn't, my clonidine just got raised the night before to try to bring down my bp as I'm allergic to everything else.

The doc on call said this was way tooo high and wasn't I the pot's pt. she had met who was the most challenging case in the practice of the other doc? I was to get out my clonidine and take it right away and if I started with a migrane I was to go right to the emergency room. I'm laying low today and not being so postural as I find being more postural brings it out. I'll try to reach my doctor on monday, as I have not felt right since my peunomionia.

I go to the hospital tomorrow for hydration tomorrow and I didn't take my florinef today as I think that is adding to the problem. I give him a running log of pressures tomorrow. I also can't breathe if I lay down I get so breathless.

I hope you figure out what is up with you and we both get better. I'm having some plummy issues as breathing tests came back abnormal.

I just hate being here all alone.

xxx's

bellamia~

[masumeh]

I just recently (relative to length of disease) found out that my blood pressure spikes with activity. The activity might be something as simple as talking, holding something, or standing up from a sitting position. Heavier activities definitely spike it. Just like you, my bp is usually very low. It may be 95/60 resting, then spike to 160/110 when walking for a few minutes. One doctor told me that this is a sign of general deconditioning that has affected cardiovascular fitness. So he said that if I do rehab, this phenomena will disappear. That was in July. I have since done rehab, and I exercise every day, and have recovered enormously from most of my POTS symptoms, but my HR and BP are still wacky. When I go back to the doctors this coming summer, we'll have some interesting talks I'm sure

The norepanephrine (excuse my ridiculous spelling sounds like a viable explanation. Another person here in this forum told me that hyperadregenic type POTS would have this reaction. If I can locate her/his post, I'll come back to this thread and link it. rather technical and I don't recall the exact mechanisms mentioned.

[masumeh]

Okay, this sounded probable. Increased activity=>increased sympathetic (ANS) activity=>increased norepinephrine levels=>elevated blood pressure and heart rate.

This is in hypertensive people; I wonder if the same chain reaction exists in normal people or which diseases and types of damage it's associated with (some hypertension results from nerve/brain damage from blood flow obstruction during sleep).

Neways, here's the article:

Changes in plasma norepinephrine, blood pressure and heart rate during physical activity in hypertensive man

RD Watson, CA Hamilton, JL Reid and WA Littler

We have investigated the changes in plasma norepinephrine and blood pressure and heart rate during a range of physical activities in eight hypertensive subjects in order to determine whether changes in plasma norepinephrine reflect changes in sympathetic activity. Blood pressure was recorded over 24 hours from an intra-arterial cannula. Plasma norepinephrine, measured by a sensitive radioenzymatic method, increased progressively with increasing levels of physical activity. In each subject a statistically significant linear relationship was observed between the logarithm of plasma norepinephrine and systolic blood pressure. Analysis of variance showed that 66% of the variance of plasma norepinephrine was associated with changes in blood pressure and heart rate. These observations support the hypothesis that plasma norepinephrine reflects short-term changes in sympathetic activity. Use of the quantitative relationship described, in conjunction with measurements of norepinephrine metabolism, may help to determine the significance of increased levels of plasma norepinephrine observed in some hypertensive patients.

[Rene S.]

Hi Nikki,

I feel your frustration. I was out yesterday and walked around too much and felt like I was going to pass out. Got out of the store quickly and while driving my heart rate was through the roof and I knew my pressure was high. Thankfully, I was close to home, for a felt a definite graying out period.

My b/p has been all over lately, but basically high. Thurs night it was at 171/75 (measured at the dr's who told me to go home and lay down) and Fri when a woke it was 94/49! Grrrr. Yesterday after my incident in the store, my b/p was high most of the day.

Tired of all this and sorry that this is happening to you and Bella.

When I had my neurepinehrines (sp?) They were sky high. Great. The debate for me is should or shouldn't I be on a b/p med? I've had conflicting answers from different drs. Very frustrating to say the least

Feel better.

Rene

[MomtoGiuliana]

I have a tendency towards high bp with POTS flare ups. But I also have episodes of low bp. It's very confusing. But I tend to feel my worst when my bp is high. Something is happening during these episodes that is limiting blood flow to the brain.

[blueskies1234]

Wow-I am exactly the same! Until recently, I thought the diagnostic criteria for POTS was a decrease in bp (and so did my docs). My bp elevates tremendously when I do any activity (talking on the phone, eating, standing etc).

I also have the extremes that have been described (180/100 vs 90/45). I think I feel bad at either end of the spectrum.

I'm learning a lot on here-thank you!

[delphicdragon]

I know that exercise raises BP. This is normal and what is supposed to happen. I had a stress test and my BP got to 160/110; and according to the cardio who was standing next to me, that was a normal response (though it usually took people more than 9 mins to get a heart rate of 200).

What I've found with my BP is it spikes right before it tanks. During my first TTT, I was having all the symptoms with a BP of 140/90 and a heart rate of 140. They kept me standing and my BP dropped to 90/0 and I was quickly lowered. The heart rate topped out around 150. You may have just caught the spike.

I have the extremes too. Usually my diastolic rises to meet my systolic. Instead of 110/60 I get 110/90. Yesterday had 89/71!

Sara

[Maxine]

I definately feel worse when BP is high. When my BP is really low I seem to have less tachycardia. When I have sudden episodes of tachycardia, despite being on the porpranolol, my BPs are usually on the high side. I'm figuring that my BPs run so low at times that my body pumps into high gear trying to fix things and my body goes into ANS meltdown. I feel really bad when this happens, and I'm become very limited. My OI becomes much worsem then what it is when my BP is low.

With low BP I feel rough, and like I'm climbing a mountain when trying to run errands, chores, socialize ect. However, I'm more functional then I am when it's high-------definately.

I've just been fighting a bout of high BP spells that were sporadic----------------------basically my BP was all over the place, like the switch for that was BROKE. This happened after waking up one morning with mid thoracic spine pain that was beyond my usual.

Maxine :0)

[arizona girl]

count me in this is me too! My BP/HR goes up and then spikes before tanking according to TTT. It was dropping to low BP/HR when I would lay down. Since I've been on labetalol it isn't swinging so much posturally. The thing is I still feel really weak and fatigued when on my feet. Oh yea mine also asks up when I'm focused working on something and or talking.

When you guys say you feel bad when it is high, how exacatly do you feel?

The longer I'm on my feet the more jittery I get and I get a ton of all over body pain, when I finally sit down I get a wave of pain for a minute or two before it passes. I only get the dizzynes, nauseau, ringing ears, palpitation and lose my vision and hearing after my BP/HR spike and then tank, as it tanks and I collapse that is when I get my sickest. So far I've managed to get to the ground before I actually pass out, once I'm down though it's like my legs are noodles and I can't stand back up for a bit.

[ramakentesh]

In certain subtypes of POTS excessive vasoconstriction or an excessive pressor response to a variety of stimuli seems to be present. Hyperadrenergic forms such as NET deficiency, low flow are to some degree vasoconstrictive forms of POTS.

[runningshoe]

My bp can be all over the place too. I also have the paradoxial thing going on. However, I can't imagine it being possible and or a good thing to train your body by standing still against a wall. I am not surprised you passed out. I think that is very stressfull on our bodies and should be avoided. I am no dr but that has been my experience. Conditioning is important but I don't think you can train the pots response out of us. Just my thoughts........

[janiedelite]

When you guys say you feel bad when it is high, how exacatly do you feel?

I have two sets of symptoms associated with my POTS. The first are the more common OI issues: feel weighted down, black spots in vision, nausea, headache, oh so tired. These symptoms occur to some degree all of the time but are worsened with heat, dehydration, standing too long, etc.

The second set of symptoms occurs under any degree of emotional stress, sometimes physical stress, also they occur while talking. These symptoms include (in order of occurrence) flushing, chest pressure, head pressure, burning of head and chest, burning mouth, head pain, and chest pain. I've found that carvedilol (an alpha1, beta 1&2 blocker) has lessened the intensity and frequency of these episodes, but I also take nitroglycerin tablets for the chest pain/pressure.

However, my BP always goes up when standing. Usually I can sit or lie down before the flushing, etc. gets too severe.

As far as training yourself to be upright, I was told at Mayo that walking is the most important activity for us POTSies because it strengthens our skeletal muscle pump and helps our bodies acclimate to upright posture. I can walk for quite a ways on most days, but ask me to stand still and I'm toast!