Blood Pressure Gone Wacky?

[Alyssa]

I'm a bit confused.

I was diagnosed with orthostatic hypotenstion resulting in syncope a few months ago. My supine blood pressure was within normal ranges (usually around 110s/70s) with resting HR in the upper 70s.

Upon standing it would plummet to 70s/40s - 50s, resulting in faint with HR in 150s (POTS).

Now I'm on midodrine (5mg 1x per day) and atenolol (25mg 1x per day) . I'm still fainting and as of yesterday, got something to monitor my blood pressure with.

It's gone wacky. Supine BP: 90s/upper50s with HR still in upper 70s. Standing BP: 130s-140s/90s HR: around 110s (readings taken immediately after standing, and then 2 minutes later). What in the world is going on? Why is my BP suddenly rising upon standing and why am I still fainting? I haven't seen my BP go below 100/77 while standing (and feeling fine). I'm pretty dizzy when its high.

Is this normal for those meds? I was thinking they should stabilize my BP, not make it flip around.

ps:These readings were done before, during, and after taking meds.

Thoughts?

[gertie]

I don't know if it's normal for your med's or not but my GP has been hesitant about giving me anything for my BP.

Doc says he's afraid if he gives me a BP pill it will make me worse because one time my BP will be 190/89 & within

a hour or so it will be 120/70. If I take something to lower my BP it will be too low. I don't know what the answer is.

Good luck!

[Alyssa]

Woke up today and took my BP: 85/60, stood up and got 140/94.

It seems I went from orthostatic hypotenstion to having orthostatic hyperstension. I'm still fainting, so I wonder if it's just randomly dropping throughout the day...?

[Katybug]

Alyssa,

I was just saying this in kcmom's post. A beta blocker can cause your BP to fluctuate and increase. In theory, that's not all bad if you have POTS because most of us with POTS don't get the BP increase when we stand up that should be causing our heart rate to come down if we were functioning correctly. But, if your heart rate isn't coming down, you can still faint. Also, too much fluctuation in your BP can cause you to faint or feel pretty bad. I'm on the lowest dose of my BB and the cardio and neuro will not up the dose because it did bring my HR down a small bit but it made my BP start to fluctuate too much. It hasn't made me sick but they are afraid that upping the dose will be enough to push me over the edge. Is there a lower dose of your BB that you can take to see if that evens things out?

[Alyssa]

Katy, I'm on the lowest dose of atenolol they offer and I really want off of it. My cardiologist was leery of putting me on a BB due to how severe my asthma is, so she did it as a last resort. It's supposed to be cardioselective, but yet it is still making my asthma act up (3-4 attacks per day with no known trigger).

Will my body ever adjust to the BB and stop my BP from fluctuating?

This is so frustrating! I think I could learn to deal with all of the symptoms from POTS if it weren't for the fainting. I feel like I've had to give up way too much because of it, and every time I start a new med, I get so hopeful! - sorry, just a little vent!!

ETA: I wasn't aware that a high HR could lead to fainting. Docs told me that even when my HR is at 190+, without a drop in BP, I won't faint... confused =/

[Katybug]

I'm with you Alyssa. I am really sick of being sick and I am boring myself. I so want to go back to work and back to having a social life.

So, my doc said just the opposite...I had no change in BP on my TTT but my HR doubled and he said he was shocked that I didn't pass out especially given how symptomatic I was. I am so over the docs giving out conflicting information because you never know what's accurate.

I really feel for you with the asthma. I had it temporarily from a bad case of bronchitis and that was enough for me to last a lifetime...I think that feeling was scarier that my worst POTS. I don't blame you for wanting off any med that makes it worse.

[Alyssa]

okay, so I guess the answer to this would be to find out how many people have only POTS and still faint. Perhaps a poll is in order?

I can't really find anything online regarding tachycardia and fainting aside from stuff about how people with POTS sometimes experience syncope.

As far as the asthma, I think the BBs are a dangerous game for me. Last year my asthma was so bad that I ended up in the hospital for 4 days while they tried to get my airways to stay open. Every time they thought I was stabilized, they closed back up. Rescue inhalers do not work for me unless I get to them at the first sign of an attack.