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Praxxtor

Pots With Hypo/hyper And Stable Blood Pressure...

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Why does blood pressure remain stable in some POTS patients and in others it either drops or increases? I've mostly understood how Hyper and Hypo Pots patients work but what about those with no change in blood pressure? You see explanations for why POTS sufferers are Hypo or Hyper but I never see explanations as to why in others the blood pressure remains stable. If anyone can shed some light, I'd appreciate it. Been researching for a while now...

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I'll stand and start to feel awful with all usual symptoms and blood pools in my legs but my blood pressure continues to remain stable. My relative has a milder case than me and she experiences a drop in blood pressure after a few minutes of standing. I just find it odd that even though I experience pooling my bp remains stable. Is it simply down to how effective the body is at compensating?

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I think it's all part of the autonomic dysfunction. Some people have tachycardia, some have orthostatic hypo/hypertension, some have GI dysfunction and some don't, some sweat excessively while others develop a complete lack of sweating. I think it is the nature of the beast. I would imagine a lot of the answers lie with each persons u drying cause/s. For example, I have EDS but I also apparently have immune issues that have MCAS-ISH and also autoimmune-ish tendencies. When I feel particularly bad I usually have a migraine and low blood pressure which is rare (usually migraine is associated with high bp). But it seems that part of my particular brand of autonomic dysfunction causes my bp to drop when my inflammation levels flare. When I take prednisone and suppress the inflammatory process my bp improves.

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I think it's all part of the autonomic dysfunction. Some people have tachycardia, some have orthostatic hypo/hypertension, some have GI dysfunction and some don't, some sweat excessively while others develop a complete lack of sweating. I think it is the nature of the beast. I would imagine a lot of the answers lie with each persons u drying cause/s. For example, I have EDS but I also apparently have immune issues that have MCAS-ISH and also autoimmune-ish tendencies. When I feel particularly bad I usually have a migraine and low blood pressure which is rare (usually migraine is associated with high bp). But it seems that part of my particular brand of autonomic dysfunction causes my bp to drop when my inflammation levels flare. When I take prednisone and suppress the inflammatory process my bp improves.

Thanks for that explanation. I'm no doctor but I just thought that if you experience blood pooling wouldn't the end result be a drop in blood pressure?

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Hi Praxxtor,

a BP that is stable (and remains stable for longer periods, i.e. for example 30 minutes) is indeed rather unusual among Pots patients!

Do you take any meds? What about your heartrate, how does it usually react to changes of posture?

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I am one of these few that has either normal blood pressure or higher blood pressure. Very often it is around 120/80 give or take. It's usually only airing on the low side in the morning before I have had something to drink and even then it doesn't really go below 90/60. However my heart rates go up regardless when standing and is at it's highest on a morning again... Around 120ish on. First standing and then 140+ whilst getting dressed etc. this generally then drops to a steadier 110-120 during the day but can rise further obviously with constant activity.

I still get lightheaded/dizziness at the moment specifically as I've bad a significant period of down time but my blood pressure doesn't really reflect this which is confusing as sometimes I'll feel quite faint but my blood pressure isn't going to let me.

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Hi Praxxtor,

a BP that is stable (and remains stable for longer periods, i.e. for example 30 minutes) is indeed rather unusual among Pots patients!

Do you take any meds? What about your heartrate, how does it usually react to changes of posture?

Hey Goschi,

That's why I'm wondering haha! I had the TTT done and my resting heart rate was 50 and by the end I was clogged at 150 bpm. I was told I experience venous pooling but strangely enough my blood pressure remained stable throughout the whole test. Why is that? If blood is continuously pooling into your legs, wouldn't the blood pressure be affected? The only advice they offered me was to do the things I'd already been doing. I'm not sure why they didn't offer me medication, could it be because my BP remains stable?

I am one of these few that has either normal blood pressure or higher blood pressure. Very often it is around 120/80 give or take. It's usually only airing on the low side in the morning before I have had something to drink and even then it doesn't really go below 90/60. However my heart rates go up regardless when standing and is at it's highest on a morning again... Around 120ish on. First standing and then 140+ whilst getting dressed etc. this generally then drops to a steadier 110-120 during the day but can rise further obviously with constant activity.

I still get lightheaded/dizziness at the moment specifically as I've bad a significant period of down time but my blood pressure doesn't really reflect this which is confusing as sometimes I'll feel quite faint but my blood pressure isn't going to let me.

Yes I've noted this from others too that quite often when they feel really poor their vital signs paint a very different picture. I wonder why that is. The wonders of POTS!

Oddly enough I find if I remain homebound for a while my symptoms improve greatly, does anyone else feel this way? Something makes me think I might have adrenal issues instead that could possibly be mimicking POTS. I say this because last year I attempted education and managed to push myself to attend each day for 2 weeks and then I simply brokedown. Took me about 6 months to fully recover. I find as long as I lead a very sedentary lifestyle my symptoms are quite alright but whenever I attempt to work/study something that requires a routine I simply crash in a matter of days.

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There could be a few ways to look at it. One the HR is compensatory, so it may be that the rate and strength is adequate. There also seams to be other compensatory mechanisms.

My condition is more stable than earlier into this. I have been sick for about two years. Earlier, I could get big drops in pressure or it would rise. I had no baseline. I had a lot of trouble managing something that was different from hour to hour, and day to day.

Now I seam to have more of a base line, where I can predict my results. I still am up and down, but I have more of a norm.

What I am seeing now is my systolic drop 10 points, and my diastolic raise 10 points. My resting PP is 30, so my Orthostatic PP drops to 10. This is after an a quick initial drop. If I continue to stand in place, my BP stabilizes, and my PP may return to 20. I will feel like cr@*, but the numbers do not look worrisome.

One of my most troubling symptoms is chest pain. I have been clinically diagnosed with coronary spasm, and micro vascular angina. And I agree that I have these problems, but I do not have micro vascular angina in a classic sense. I do not believe that I have any narrowing or hardening. I am convinced my chest pain is mild to moderate ischemia, resulting from alpha adrenergic over activity. My theory is that it is compensatory. Though it seams irrational, it at least has a rational explanation. I have peripheral autonomic neuropathy, and this malfunction there leads to apparent dysfunction elsewhere. Compensatory over activity.

So the point is that there is more at work than the HR and BP. My BP can appear normal enough, and my HR may be under control, and still feel awful. Or they can be a little more out of wack, and feel better. These two are only indicators that we can measure. There is a lot we cannot see, or measure. It very well maybe that your HR is enough to compensate for you, at least as far as managing BP.

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Hello. I am brand new to DINET but was diagnosed w/ POTS and EDS a year ago. I typically deal with low BP on the days I can't seem to stay upright but occasionally have elevated BP after or while coming out of an "episode" as we call them around my house. However, frustratingly enough I have had normal vital signs even during Pre- syncope during an echo at a cardiologists office in which I drooled, went numb on one side and could not speak or see.

For what's that's worth I have been there on the feeling totally sick and having normal- or only slightly elevated vitals.

Finally my very awesome new cardiologist who diagnosed me confirmed that chest pain is quite common in potsies( our words not his) and has to do with the heart pump being overworked from blood pooling. I have no other medical explanation in my case for my pain other than this but it can be quite bothersome on days when I push myself or am upright for too long. In my almost year and 1/2 of living w/ POTS I have seemed to only learn more about how elusive it can be and so very specific to each patient. Arrr! Thanks for posting! Learning a lot here :))

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