Does Orthostatic Hypotension really cause brain damage?

[Peter Charlton]

All my Dysautonomia symptoms started from the day they put me on Bisoprolol beta blockers for Ventricular Tachycardia.

Its hard for me to know which symptoms are a result of my heart or a result of my Dysautonomia.

The very worst symptom is the brain fog that can make me feel like I am slightly drunk and have to try hard to walk in a straight line.

When I was assessed at the Neurology hospital they did an Autonomic Blood Pressure test which saw my Systolic fall by 20 and my Diastolic fall by 13 which I understand is well within the criteria for Orthostatic Hypotension.

Then yesterday I found this:- https://med.nyu.edu/neurology/dysautonomia-center/research-trials/current-research/orthostatic-hypotension

I was somewhat alarmed to read the line:- "  We will determine whether the disease process always damages neurons in the brain (resulting in a movement disorder and/or signs of dementia) "

So, does Orthostatic Hypotension "always" give you brain damage?, is this why I feel I have brain damage?

[WinterSown]

If you read the study they've yet to determine that it always happens.  The fog can be brutal at times but it can and does lift. I've dealt with it in my own way and have improved a lot just by studying and being creative. Talk to your neuro about setting up a program ton help lessen the fog and do more.

We will determine whether the disease process always damages neurons in the brain (resulting in a movement disorder and/or signs of dementia) or can, in certain cases, remain confined to the autonomic nerves outside the brain.

 

[Peter Charlton]

22 hours ago, WinterSown said:

If you read the study they've yet to determine that it always happens.  The fog can be brutal at times but it can and does lift. I've dealt with it in my own way and have improved a lot just by studying and being creative. Talk to your neuro about setting up a program ton help lessen the fog and do more.

We will determine whether the disease process always damages neurons in the brain (resulting in a movement disorder and/or signs of dementia) or can, in certain cases, remain confined to the autonomic nerves outside the brain.

 

Thanks. Any idea what causes the possible damage?, is it lack of oxygen as the blood pressure falls or something else?. I have had mine a year now and it seems to be getting worst. What creative thing did you do that helped?

[WinterSown]

14 hours ago, Peter Charlton said:

Thanks. Any idea what causes the possible damage?, is it lack of oxygen as the blood pressure falls or something else?. I have had mine a year now and it seems to be getting worst. What creative thing did you do that helped?

 Causes of dementia or loss of clarity and recall are unique to the individual, your health and history add into that. I remember asking her about long term partial deoxygenation and she said that was not my cause. I have vertigo and sensory overload issues that can also make me wig out,  there's an assortment of scripts; I have a lifetime of reasons that are possible so we treat the symptoms.

I do things that I love doing, that's the key to success. DINET just published its quarterly online newsletter, they published an article about how I am succeeding with a self-styled neurotherapy program, it's called 'Walking out of the Fog'.  It's a good edition, enjoy.

 

[TCP]

I've always believed it is because of the drop in the blood/oxygen flow for brain health. I have noted that people who have improved through diet, upping fluid intake and exercise say that their brain fog improved too. 

PS< I've had it since 1984 and I am still pretty bright and also the fog comes and goes. 

[bombsh3ll]

Hi Peter,

I worry too about the long term effects of chronic cerebral hypoperfusion - it can't be good! 

However as a doctor myself I would add that although there is an association between OH and dementia, it does not prove a) that one causes or leads to the other or b.) the direction of causality. For example some degenerative diseases seen in elderly people have both cognitive decline and OH as features. 

It sounds as if your problem stemmed from an event that you can identify, that is not related to degenerative disease or dementia. 

Also on the plus side for you, if your blood pressure drops when you stand up there are a number of effective treatments available for this aimed at raising BP. Have you tried any vasoconstricting meds yet?

B x

 

[Peter Charlton]

6 hours ago, bombsh3ll said:

Hi Peter,

I worry too about the long term effects of chronic cerebral hypoperfusion - it can't be good! 

However as a doctor myself I would add that although there is an association between OH and dementia, it does not prove a) that one causes or leads to the other or b.) the direction of causality. For example some degenerative diseases seen in elderly people have both cognitive decline and OH as features. 

It sounds as if your problem stemmed from an event that you can identify, that is not related to degenerative disease or dementia. 

Also on the plus side for you, if your blood pressure drops when you stand up there are a number of effective treatments available for this aimed at raising BP. Have you tried any vasoconstricting meds yet?

B x

 

Hi B, Another of the symptoms I developed as soon as they put me on Bisoprolol, (to which I soon developed anaphylactic shock), was the feeling my lungs no longer worked automatically, and I had to remember to breathe, this becomes particularly problematic when I am asleep, see my graph.

As for my blood pressure, countless times during my investigations it was described as "perfect", after the Bisoprolol business a year ago, my blood pressure is now too high, generally around 147 over 96, so I dont think I should make this any higher. 

I would also worry about taking vasocontrictors as yet another of the many symptoms I developed from the day I took Bisoprolol is a horrendous heartburn that can come and go just like that, but does not respond at all to prescription ant-acids. I am wondering therefore if my ANS is causing coronary vessel spasm as I took the following ecg when such was occurring. You see how the T waves are up to 3 times higher than the proceeding R waves?,  Well I read on cardiologist sites, "Be suspicious of LAD occlusion when the T wave towers over the R wave, and would guess a blockage is a blockage wither caused by a build up of plaque or a CAS constricted artery? So I would be concerned about constricting them further until this has been looked into.

[Bluebonnet08]

I haven't heard anything about this or seen any research studies on this in regard to the condition.  I do know that many medications have been shown to contribute to dementia/decreased cognitive function over time... so that would have to be teased out of the study.  As far as I understand the condition, the body is trying to self-correct,  the HR increases so that the blood pressure doesn't stay low.  That is just my understanding though.  Obviously much more research needs to be done.  

As for your personal experience, I've also found that medications can have many and unexpected side-effects.  They effect each person differently too.  If you feel like you are having weird side-effects, it's definitely something to look into further.  

[bombsh3ll]

12 hours ago, Peter Charlton said:

my blood pressure is now too high, generally around 147 over 96, so I dont think I should make this any higher. 

I would also worry about taking vasocontrictors as yet another of the many symptoms I developed from the day I took Bisoprolol is a horrendous heartburn that can come and go just like that, but does not respond at all to prescription ant-acids. I am wondering therefore if my ANS is causing coronary vessel spasm

Ah I understand your concern about vasoconstrictors. Beta blockers can raise the blood pressure through unopposed alpha adrenergic stimulation, but I am not sure why this would have persisted after stopping them. 

I too tend towards higher BP, & believe in my case it is as a result of intense sympathetically mediated vasoconstriction secondary to hypovolaemia, so that category of meds is out for me too. I wouldn't touch a beta blocker myself as they reduce cardiac output and cerebral blood flow, although I know some patients with POTS do find them helpful. 

What was it that led to you being prescribed the beta blocker in the first place? 

B x

[Peter Charlton]

11 hours ago, bombsh3ll said:

What was it that led to you being prescribed the beta blocker in the first place? 

B x

 

[bombsh3ll]

Blimey that looks like a nasty ventricular tachycardia! As I understand it, and I'm no cardiologist, beta blockers work on the sinoatrial node which controls HR when a person is in a normal or at least atrially generated rhythm. What was your underlying diagnosis?

[Peter Charlton]

4 hours ago, bombsh3ll said:

Blimey that looks like a nasty ventricular tachycardia! As I understand it, and I'm no cardiologist, beta blockers work on the sinoatrial node which controls HR when a person is in a normal or at least atrially generated rhythm. What was your underlying diagnosis?

Right Ventricular Outflow Tract monomorphic VT, sustained, I was getting it all day and every day as I couldn't take beta blockers, it would go away at night until the last time when after 12 hours of a 150 BPm VT, I thought I better call an ambulance!, they wouldn't let me go home until they ablated it.

So I saw my cardiologist today, bearing in mind it has been so hard to get anybody in the NHS to listen to me that Bisoprolol gave me Dysautonomia, and it didn't go away when I stopped taking it, he had apologised before and he did so again for previously having said it must be anxiety. Well today he informed me that he mentioned me to another of his patients, who has had exactly the same negative experience with Bisoprolol as I have. I cannot wait to tell the GP who barked at me "you wont find a doctor in the country who will admit Beta blockers are to blame".