Pots And Hypertension

[Achilles2323]

Can pots cause hypertension ? If so why ?

[arizona girl]

Yes there is a sub group of pots that have standing or orthostatic hypertension. Dr Grubb diagnosed me with it calling it a hyperandrenergic form. It drops as soon as I lie down.

There are theories being researched right now as to why this is happening. In my case because I do have documented autoimmune small fiber autonomic neuropathy. We have also documented that I also have a significant surge in norepinephinre upon standing. We thin, that in my case that is a compensatory response to my blood pooling as a result of my sfn nerves not being able to constrict my blood vessels on standing. When your body does not do that as it is suppose to then norepi kicks and constricts them as part of the fight or flight response. This often causes an excessive release of norepi, which then results in high bp and hr on standing.

Dr. Grubb put me on labetalol to help calm that response it is an alpha/beta and also helped with the supine hypotension and bradycardia I was getting while sleeping.

This response has also improved as we have addressed and treated my underlying cause of this response which in my case is a combination of autoimmune disease and an immune deficiency call cvid.

High bp that is continuous regardless of body position supine or standing is considered essential hypertension and not a feature of pots.

[andreak]

I find your reply really interesting

My daughter is 18 and was diagnosed with POTS around 18 months ago along with Ehlers Danlos. She also has Complex Regional Pain Syndrome

Because of the pain and symptoms worsening aroung the time of menstruation she was placed on a combined pill, the mini pill having not agreed with her

The clinic who prescribe the pill take her blood pressure and we have found over the past couple of years this has risen from normal 114/80 steadily in the top reading to 134/87 after one year and was 144/121 at the last reading a couple of weeks ago

Her cardiologist has written to the clinic stating that she may remain on the combined pill as it helps with symptoms but I do worry that the readings are increasing

When the clinic take the readings it is usually straight away after standing and walking into the office and they then retake a couple more times and the reading increases slightly or stays the same. For my daughter this is normal POTS behaviour

I was wondering of those of you with hypertension what are your readings and do you notice these come down

We have access only to a limited number of tests as we live in the UK and the NHS will not fund extensive tests beyond diagnosis

We have a further appointment late next week at which we will discuss matters. The only medication she takes atm is Sertraline for the POTS and also oral Ketamine for pain - would either of these cause an increase in BP

In addition does anyone use one of the combined pills designed to stop periods and have you noticed any increased problems with POTS symptoms

Thanks

[bebe127]

Interesting Arizona girl.

I wish I had this explanation 4 years ago!! I was dx. with "what is probably POTS" via TTT (2009) by an EP after an ER visit (my first and only one). He told me that he doesn't treat POTS and didn't know of any dr. that he could refer me to. Left me with the following words of wisdom, "Eat more salt, drink more water, and go live a normal life." I began seeing a GP a few years ago that put me on a BB and Xanax. Before being put on meds my bp would raise to the 140's/100's and of course would freak me out which only sent my bp even higher. I have suspected for some time now that I might have hyper POTS, but don't know what to do about it. Before I got sick I was dx. by a cardiologist as having high blood pressure and my OBGYN said I had high bp once. My rates were in the high 130's/high 90's at the time. Before the BB I was placed on Norvasc. This was all before my ER visit. While at the ER the dx. EP told me, as well as the attending dr. that I, in fact didn't have high bp and instructed me to stop taking the Norvasc. At my TTT my blood pressure raised instead of lowering and my hr went from 60's-70's all the way up to 155+ within three minutes. To this day, no dr. has ever suggested what type of POTS I have nor suggested any tests be done to see what type I have. My NE levels have never been checked. I hope I'm making some sense, I feel like my description is all over the place

Thank you so much for your post. I have printed it out and am going to take it in to my GP next week when I go in for my physical.

Bebe

[ramakentesh]

if your asking whether POTS can cause essential hypertension - as in sustained and constant increases in blood pressure - then the answer would be no. If your asking whether POTS can cause sporadic increases in postural blood pressure while upright then definately yes.

All forms of POTs can present as a hyperadrenergic response - neuropathic sometimes, NET deficiency sometimes, low flow POTS sometimes, and even hypovolumia with normal vascular control or dehydration can result in postural hypertension.