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HyperPOTS, hypertension and pooling?

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I'm sorry that I can't seem to be able to figure this out, even with the constant Googling... So could you please explain to me how is it possible to have high blood pressure, without vasoconstriction? I mean, my husband clearly has some serious adrenaline/norepinephrine storming when he's upright, and his blood pressure rises from average 145/95 to 155/105, and then there's blood pooling down into his arms and legs... So if the blood pools, his veins are bulging in his purple feet and heavy hot hands -> no vasoconstriction? Then what makes his blood pressure rise?

Is there any use to measure blood pressure from the ankle and compare the numbers to the results from the arm? 

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Interesting question.  My guess is that just because there is bulging veins doesn't necessarily mean that there isn't vasoconstriction.  Perhaps the bulging occurs because the arterial force in the feet caused by gravity is greater than the vasoconstrictive force?

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You're right, there IS constriction after all, I found this study:

 "Our results indicate that orthostatic hypertension is common and that its mechanism in representative patients involves excessive orthostatic blood pooling, which results in decreased venous return, decreased cardiac output, increased sympathetic stimulation (presumably through low-pressure cardiopulmonary receptors), and excessive arteriolar, but not venular, constriction."


So the arteries constrict but the veins are floopy and blood pools, and if I understood this correctly, the reason why my husband's already high blood pressure rises even more upon standing, is the pooling in the veins.

So much to learn...

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Not necessarily. I'm a high Bp, considered HyperPOTS with high standing NE. With me, we just found APS which is an issue with blood viscosity. Too thick blood. I also have EDS and find I do better to vasodilate, rather than constrict. Whether or not that's because of the too thick blood - not sure. But I have fluid build up in my legs and feet too. And what appears to be blood pooling. If blood is too thick it doesn't move upwards easily. If blood is too thick it can push fluid out into tissues. We have faulty veins. Apparently our legs and muscles don't pump the blood up and there is a compensation with a norepinephrine release to increase heart rate and help to move blood up since the leg and veins are not doing it. Tachycardia is a very uncomfortable feeling, but probably is very necessary. May be a compensation to save us. I'm thinning my blood with herbals and treating a found fungal/mold problem and addressing issues with choline and calcium channels. I'm better than I have been in years. 

You are right, there is so much to learn. 


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