What Is Hyperpots?

[puppylove]

I was wondering what hyperpots actually is? How is different from "regular" POTS?

[HopeSprings]

My understanding of hyperpots is higher norepi levels standing, plus high BP or large jump in BP upon standing.

This is from Dr. Grubb:

A second (and less frequent) form of POTS is termed the “hyperadrenergic” form.⁹ These patients often describe a more gradual and progressive emergence of symptoms over time rather then an abrupt onset. Patients with hyperadrenergic POTS often complain of significant tremor, anxiety, and cold sweaty extremities while upright. Over half of these patients experience migraine headaches as well as a significant increase in urinary output after being upright for only a short period of time. A characteristic of this form of POTS is that patients will often display orthostatic hypertension in addition to orthostatic tachycardia. Many will also have an exaggerated response to intravenous isoproterenol, as well as significantly elevated serum norepinephrine levels (>600 ng/mL) on standing. The disorder often has a strong family history. A study by Shannon et al found that some patients have a single point mutation that produces a poorly functioning reuptake transporter protein that recycles norepinephrine within the intrasynaptic cleft.¹⁰ This process leads to an excessive degree of norepinephrine serum spillover in response to a number of sympathetic stimuli, producing a “hyperadrenergic” state (similar to that seen in pheochromocytoma).

http://circ.ahajournals.org/content/117/21/2814.full

[puppylove]

Thanks!