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Orthostatic Hypotension And Pots

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I have a question about those two things. I noticed the drop in blood pressure upon standing about 5 months ago. I also felt the irregular heartbeats and knew my resting heart rate was fairly high, but I never measured my heart rate from sitting to standing like I did my BP. Anyways, I have recently read this:

It should be noted that many patients with orthostatic intolerance due to POTS will not demonstrate orthostatic hypotension (defined as fall of >20/10 mm Hg on standing). Instead, they may display no change, a small decline, or even a modest increase in blood pressure.


I know that I have an obvious drop in blood pressure when I stand as that has been documented by me and doctor, (not TTT), but I also get lightheaded when I stand up. However, when I stand up my heart rate also increases. When I was at the doctor sitting my HR was 80 something and then when I stood up it went to over 120. He did not measure my BP though.

Do any of you have both? I'm wondering if I have something else going on? I thought they went hand in hand until I started reading a little more online.


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Thank you both for the reply. I just want answers. I am actually seeing a different cardiologist tomorrow. Hopefully she is more attentive to what is going on and tries to figure it out other than tell me to just get on a bike. I can deal with the BP, I think, I just can't imagine that it's normal or good to have a high HR. I feel so winded after walking upstairs.

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Hi hopeforthecure,

I have a diagnosis of orthostatic hypertension that is separate from my Pots (with a hyper component). The diagnostic criteria for Ortho Hypertension (don't quote me) is I think an increase in 20 points in Systolic Blood Pressure. I remember in the beginning feeling really overwhelmed and confused by all the diagnoses. I hope you get answers with your new cardiologist and she can help you navigate, good luck at your appointment.

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I have trouble with heart rate and low blood pressure, especially when standing. I take midodrine 10 MG 5 x a day and florinef 0.15 3 x a day to help manage BP. My resting heart rate is variable jumps around from too slow (30s) to super fast (240s), standing amplifies this problem. My blood pressure tends to be ok as long as I'm reclined or almost supine, however, positional changes tend to cause major fluctuations (140s/80s- 40s/20s and anywhere in between) to the point of causing syncopal episodes. I currently cannot stand longer than a minute without passing out, always thought that it was just my BP causing it but my cardiologist told me at my last appointment that I could also be passing out because of HR when it exceeds 200 bpm.

Cardiologist is trying me on Corlanor to lower my heart rate which has been helping. My heart rate average has lowered and the occurrence of 200+ bpms has decreased. I have also seen that the stabalizing of my HR has also somewhat stabilized my BP.

I have been diagnosed with POTS, NCS, NMH, OH post TTT. All of these fall under the umbrella term dysautonomia and have a high occurrence of co morbidity.

I hope you and your drs can figure things out.

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