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High diastolic bp after excercising? POTS


Sam4877

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Hi I have POTs but when I stand up from a sitting position the hr goes up 30+ and bp rises slightly, if my sitting bp is 125/82 then standing rises to 128/90 then it drops down to 118/82. I expiremented after running a bit that my bp rose to 145/100. Is this normal? My main concern is that the diastolic is rising too much but then it falls quickly too with the next measurement. Most people on the internet say that only systolic rises during excercise but no one talks about diastolic. There is very little information about diastolic rises. Does this temporary spike during excercise harm me? I am suspecting I have hyper-pots because I have never fainted but hr rises above 100.

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Hello @Sam4877 - welcome to the forum!!! I have hyperPOTS and in my case the HR and the BP go up. Diastolic hypertension is typical for hyperadrenerdic POTS. I can tell when my BP is above 130/90 and when it hits 140/100 I am in a surge. 150/100 and I pass out or take seizures. I rarely get tachycardic anymore due to my many cardiac meds but I still develop hypertension frequently, and my BP changes from minute to minute. You mention that your BP rises after running - that is normal but the diastolic should not rise above 90 ( as you mention is does for you ). You must tell your doctor about these readings and keep a log about the BP's to take to him. Are you on any meds at all? You also should be referred to a cardiologist for cardiac work-up and hopefully a TTT. Good luck!

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@PistolHi thanks for the reply 😀 I have had several ecgs, echocardiograms, holter monitors and when I had my TTT the bp fell instead of rising. The weird thing is that my bp spike when standing only lasts a few seconds then returns to normal. But when I walk or run the diastolic rises with systolic so if my systolic is 140 the diastolic will be 100. If I work out sitting only the systolic rises and disstolic falls slightly. I have never taken any meds. I suspect this is from vasoconstriction/hypovolemia when I am standing. What meds do you take?

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@Sam4877 Have you ever had a stress test or stress echo? I also second the log idea! I kept logs and even made little videos on my phone to show my doctors how severe my hypertension and tachycardia actually was. I tried 5 different beta-blockers before my doc decided I wasn’t a candidate for them. So I’m currently on Clonidine for my hypertension and I just started Ivabradine a few weeks ago, which has - so far - helped limit the amount of tachycardic surges I have. 

Best wishes. 

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@Sam4877 - you asked about what meds I take: for my HR and BP I take carvelidol ( BB ), diltiazem ( calcium channel blocker ) and guanfacine ( also called Tenex ). This cardio-mix has proven to be very effective for me but it took years to get it right. Either of these meds by themselves do nothing. Yes - in my case I suffer mostly from excessive vasoconstriction but also get syncope from drop in BP due to vasodilation. When I am too active ( which is essentially just walking too long or standing or bending too much ) my diastolic goes up, the systolic not too much, sort of like yours. 

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  • 2 weeks later...

Just wanted to second what a lot of folks above have already said.

I similarly get a significant rise in diastolic when exercising, but not always. It really is very odd, and I think there are so many variables regarding what sets off a surge etc. 

Make sure your heart has had a good check over by a cardiologist, and, if all is well there (which I am guessing it will be - it seems that most people with dysautonomia have fairly healthy hearts) then you will likely need to try some meds (beta-blockers, or perhaps clonodine. A specialist will need to help you with that) which will bring it down and help in that area.

Sending positivity your way! 

 

 

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