Has Anyone Ever Noticed They Have A Wide Pulse Pressure Or Narrow One? Also Possible Reason For Pots

[RichGotsPots]

i know many of us use BP monitors and I just thought it would be interesting to take a poll on this. I know many of us have Hyper or Hypo BP issues and some of us have both but I've just realized today that my Pulse Pressure is really wide. During my last TTT is was as wide as 144/62 a difference of 82 mm Hg and tonight when I was having breathing issues it was 108/32 a difference of 77 mm Hg

So I looked up info about Wide pulse pressure and the causes i found were varied depending on if the widening was due to:

Systolic increase Wide pressure indicated:

-hypertension

· increased heart rate

· hardening of the arteries

· atherosclerosis

· plaque in arteries

Dystolic decrease Wide pressure indicated:

-shunting from arteries to veins

· shock

· loss of arterial tone

· regurgitation of the aortic valve

I have heard people on here mention regurgitation come up on echo's and doctors just blow it off as not...

Also I looked up shunting from arteries to veins and that is hard to research but ultimately lead me to realize that shunting can happen from trauma and viruses. A light bulb totally went off... Could it be we have some kind of are to trace fistula (shunting) causing our POTS.. There are 4 ways to find out according to Mayo Clinic. #1 the doctor hears a clicking where the fistula is #2 duplex ultrasound (of arms and legs) #3 MRA angiogram #4 CT angiogram. The problem with #1, and #3 is the doctor has to already have an idea of the area it's in to hear it or see it. the problem with #2 is it's only images of the arms or legs and not the brain, chest or stomach area. MRA seems like the best test but it's also like finding a needle in a hay stack...

[RichGotsPots]

so far 2 wide, 3 narrow, 1 neither....

[angelloz]

I haver wondered about this....but I have had both...don't know what this means.

Angelloz

[RichGotsPots]

I haven't monitored my BP enoug, just started since taking this new BB but also it was wide on my last TTT. I've had close to narrow once or twice but not more than 15 mm Hg/

[Kellysavedbygrace]

I've been paying more attention to this since Feb when I had a low pulse pressure of 13. I've been tracking mine on and off since last Nov. Using my Heartwise App on my iPhone- in stats it shows me my avg PP is 32. My high is 56 and my low is 13. Am symptomatic with both high and low PPs.

[Kellysavedbygrace]

As a side note I tend to see a better correlation to symptoms when my Mean Arterial Pressure (MAP) is low. Anything below 75 and I am symptomatic and probably in bed. My average MAP is 79. My high is 109 and my low is 44.

Did I mention this is a cool app?

[peregrine]

At my TTT I had both a wide (170/100 = 70) and narrow (62/50 = 12) pulse pressure. During regular doctor's visits, it's ranged from 18 to 63, but is usually in the 30-50 range.

[RichGotsPots]

At my TTT I had both a wide (170/100 = 70) and narrow (62/50 = 12) pulse pressure. During regular doctor's visits, it's ranged from 18 to 63, but is usually in the 30-50 range.

Sounds just like me. The only time mine is narrow is if both are low.. But can be wide regardless..

[SoliDeoGloria]

So glad you started this discussion because pulse pressure has been a concern of mine. When I am laying down or sitting, my pulse pressure is pretty normal (about 40). But when I stand up it drops to about 20. The longer I stand, the lower it gets. I can hydrate myself into the bathroom all day and I see very little change, if any, in pulse pressure. Does anyone have any ideas what might influence pulse pressure?

[NMPotsie]

The widest I've ever had in the doctors office was 154/52, and the narrowest was 140/120 neighborhood.

[Wendy C.]

Mine has been as low as 29 and as high as 60, but usually runs in the 35-40 range. Whenever I am on Florinef it is always high, in the 50's.

[RichGotsPots]

Gloria, in my initial post I listed what are potential causes for either one.

[kds]

I've been tracking my BP intermittently since Sept. 2011, using a Withings monitor and iBP on my iphone. The gadgets work reasonably well, but produces error messages when I am most symptomatic, so my extremes are probably under-reported. I began self-monitoring after I was diagnosed with EDS and learned about the link betweem EDS and dysautonomia. I was curious about whether what I had been told was ADD was in fact POTS, and it became clear pretty quickly that lowish pulse pressure - anything in the 20s or below corresponds to what I'd thought were ADD issues. Looking at the aggregate data, I am tachy when I have low pulse pressure. I also feel unwell with BP surges that push the PP to more than 50-55, though HR with this is extremely variable. I've been unsure about whether POTS is the best way to frame my dysautonomic issues. I ususally make the 30bpm cutoff on a poor man's TTT, my resting supine HR is 50-60bpm and I will often settle in at an upright HR in the high "normal range" - i.e. the tach My averages look fine (albeit borderline high for the BP), but swinging across this range is no fun. Any advice on questions about this to bring to upcoming appointments with dysautonomia specialists would be appreciated. I should note that I only have about a half dozen measurements each above and below Rich's thresholds of 65 and 15 - i.e. more than a few, but not sure about my choice to count it as "many." I definitely have many PP measurements in the 55-65 or 25-15 range.

467 Readings High Avg Low Systolic 180 127 98 Diastolic 119 86 52 Pulse 114 74 50 Mean Arterial 139 100 77 Pulse Pressure 93 40 13

[joyagh]

My BP and pulse pressure vary greatly. Sometimes I get 90/50, sometimes 126/82. Then sometimes I'll be 120/60, and other times I'll be 90/75. It's bizzarre. I'm trying to start a log where I note the BP, pulse pressure, as well as what I'm doing and symptoms.

[Batik]

I've seen narrow pulse pressure defined as anything under 25. Mine dropped to 19 this morning. I ended up collapsing after lunch and being taken to Accident & Emergency, where they were almost entirely uninterested in my BP and HR (which were moderately well-behaved while I was there, although my pulse had got up to 114 this morning), and didn't seem to think the low pulse pressure was an issue. Oh well. They did at least check me out thoroughly, eventually diagnosed a UTI infection, and agreed that I needed to see that specialist I was mentioning ASAP.

[southbel]

I was going to ask my Cardiologist about this when I see him next. My pulse pressure varies widely, everything from around 70 to as low as 10 (but I usually get a lot of errors from the BP machine when it's this low so it's hard to capture). I feel symptomatic with both but in different ways. When it's really wide, I have chest pain and tightness, palpitations, and generalized pain (mostly in my leg) even if my heart rate isn't up. When it's very low, I usually am standing, have a very high heart rate, dizziness, and will usually pass out or almost pass out. I usually sit right around 50 though as a 'normal'. I am newly diagnosed and have gotten progressively worse in the last three months so 'normal' is completely relative for me right now.

My BP laying down before I got much worse was usually 90/60 to 80/50 with a heart rate of 60. Now it tends to be around 100/50 with a heart rate of 60-70. Standing up, I typically see 120/90 to 130/110 with a heart rate of 130-160. Oh and then there's those odd days where I will have a few hours and everything seems perfectly normal. I really don't understand this disease!!

[Guest Alex]

my pulse pressure varies a lot and I haven't found any correlation between my symptoms and my bp/hr/pulse pressure.

I believe the highest ever was 160/100, so 60, while the lowest was 97/82, so 15. I felt horrible when my bp was 160/100 (I'm normally hypotensive) and I was absolutely fine at 97/82. Can't recall the associated heart rates.

Alex

[Guest mattgreen]

My pulse pressure is narrow, certainly. It is narrower upon standing (when the veins are prominent and dilated at the extremities).

[Batik]

The highest PP I've had was 90, when my BP was 152/62 when I was just sitting peacefully after lunch. I've also had a PP as low as 12, when my BP was 93/81, and on another date when my BP was 126/114, again while sitting down shortly after a meal.

[peregrine]

Batik - don't recall from other posts here, but do you have issues (more severe symptoms etc) after meals normally? I know some folks have issues with large meals and drops in blood pressure/abdominal pooling during those times, and it seems like your blood pressure (and pulse pressure!) might be tied with eating?

[Batik]

I do sometimes have issues after meals, notably breaking out in a sweat, and on some occasions getting violently itchy (lasting for days), abdominal pain before I'd finished eating, diarrhoea half an hour later and so forth. Yes, I suspect mast cell problems too, but I think I'm going to have to wait until I get to the POTS/ME specialist before I will be able to talk about it with anyone. It's ludicrous - I'm now on three different antihistamines, cemitidine which is something to do with histamine as well, and quercetin, of which only the last is non-prescription, and they still won't talk about mast cell stuff. Vague mutterings about allergies is the best I've had so far, and I really don't think it's allergies, I'm not reacting consistently enough.

[monica]

I take my BP with a Withings BP cuff and I too am unable to take get a reading on it when I'm the most symptomatic. According to my iBP app, my average PP is 28, highest is 50 and the lowest is 15 (This is obviously considering that I'm unable to take many recordings when I'm symptomatic).

I feel the worse when my PP is below 20 and usually feel faint when it happens. The 2 times I was able to take recordings just when the presyncopes started, my PP was 18 and 19 respectively.

Batik, I too have issues after meals... the last 6-7 times I had presyncopes/fainted, it was within 1 hr of eating. At first I thought that maybe it was because I'm having large portions, so I have been cutting down the portions drastically. But then it happened after eating a small scone, so I don't know anymore what is going on?! It's always the same symptoms during the presyncope... feeling hot/flushed/sweating, stomach pain/gas, nausea, ringing in ears and down I go......

I also get diahhorea/have to urinate afterwards.....

[Batik]

Is it close to any particular meal? Maybe there's something else going on at that time of day, perhaps related to medication? Although that wouldn't fit with getting reactions to a snack, would it. Specific dietary triggers, maybe?

[monica]

I was not taking any medications at these times , so definitely not medicine related. Also, had different kinds of food when it happened and have had the same foods later too to see if it's food allergy but I was fine. One thing though is that none of these foods were home-cooked..they were either from a restaurant or processed.

[Batik]

MSG or something like that? Higher levels of oil?

I get the thing where a food will be fine for me at one meal and then I'll come over all itchy or sweaty the next time I eat it. Not a clue what's going on there. I am, however, starting to suspect that the reason why I tend to get annoyingly itchy in the evening is nothing to do with what I eat and more to do with when I take my meds, or perhaps the natural cycles that the body goes through over the course of the day (not that I have any idea what hormones or what have you are doing what in the early evening, mind you).