Blood Pressure Vs. Pulse - Too Low Vs. Too High

[lindauerin]

So, I'm still uncovering what exactly is causing my POTS or POTS-like symptoms. I suspect adrenal fatigue / pituitary / thyroid or something along those lines. Aside from the typical POTS stuff, I have hyperpigmentation and swelling (both generalized), flushing in my hands and some other odd symptoms. Endo ruled out Addisons; rheumatologist didn't have much to say. In the meantime, while my test results come back "mostly normal," I'm taking a beta blocker (propranolol 5-10 mg three times a day) to help control my heart rate. The problem is that I have pretty low blood pressure to begin with - 100/60 and prior to all of this, my resting pulse was around 60. I was feeling ok this morning, but checked my blood pressue about an hour after I got up anyway and it was 88/47 while working at the computer. Despite a large cup of coffee, I couldn't get it higher than around 95/50 all morning. Seeing 80s and 40s makes me kind of nervous. My pulse drops to 50 and probably goes much lower when I'm asleep. When I started the beta blocker a year ago, my blood pressure wasn't dropping so low. I know others have pretty low resting bp - what are your thoughts? Anything to worry about? I don't really want to start any new drugs until one of my docs can figure out the root cause (based on the other symptoms, I'm guessing it's not just POTS, but I think maybe we all feel that way!!)

[Mydoggielovesme2]

Hi, I too have low BP. I usually run 80/60s during the day, and 70/40s at night. I was on propranolol also, but had to go off of it. In fact I have been on several beta blockers, but have had to discontinue them. I was just at mayo so I can share some of their instructions. of course everyone is different so please use your own judgement. 1.compression thigh high hoses 2.use an abdominal binder 3.large volumes of fluid, 2.5L daily with half of that to contain electrolytes 4.elevate head of bed 4-6inches 5.exercise to strengthen lower limbs and Ab muscles. 6. Initiation of a cardiovascular exercise regimen.(recumbent bike)

I know these are pretty basic things for POTS patients. But I hate how I feel with the low BP. It is so hard to function, think ect. So I keep hoping that these will help.

[Mydoggielovesme2]

Have you been on midodrine yet?

[lynnie22]

Hi,

I can relate. I have been on propanolol 10 - 20 mg two times a day (every six hours during the daytime) and have also found my blood pressure to have dropped during the day. I do not take it at night because I figure I am lying down and don't need it for the pulse rate. Sometimes my pressure however goes very high and then I take much more. What is important is what mydoggielovesme said about electrolytes and plenty of fluid and salt. I don't even take my first dose until my bp is above 100/60 in the AM after about 16 oz of water. I think part of it is dehydration in the AM, at least for me. Everything mydoggielovesme suggested sounds good. DRINK. Not necessarily coffee, which can dehydrate, but water with electrolytes or water with salt or V-8 juice, one of my favorites. One of the problems with propanalol although I'm still on it is that it does drop the blood pressure, but true of all beta blockers. Midodrine is a good suggestion too, I can't take it because of my spikes, but start with fluid and support stockings and see.

[lindauerin]

Thanks so much to both of you - all great suggestions, some of which I haven't yet tried! I've been hesitant about midodrine because I can easily get an intractable migraine that lasts for a week or longer ( and have heard many say it makes migraines worse). And I also have generalized swelling, so electrolyte drinks tend to make me retain more...kind of a vicious cycle!

[imapumpkin]

have to echo lynnie here: WATER, V8, stockings and knee-bends (as well as what the call pedal pushing...extend your legs and push down like you are stepping on the breaks of your car, then flex back up.) to get circulation going in the legs. sometimes i get into the 80s/50s at night. i'm told this is lower than my dr would like but if i'm not having symptoms it's less worrisome. You mentioned your pressures throughout the day and...how are your other symptoms? Like if you're at 70s/40s are you feeling very faint and weak or do you feel fine and simply have low bp readings?

[lindauerin]

Thanks - I wear compression stockings, drink lots and do calf raises and squats throughout the day to try to keep the blood moving. As far as symptoms, I sometimes feel sluggish and slow when my b/p is low, but not always. So the symptoms don't always correlate with the pressure. I tried taking a slightly lower amount of propranolol this morning (I cut the tabs in half and chip away at them)...will see where I'm at in an hour. Thank you all for the advice!

[Angela]

beta blockers don't really help pots from what i've read.