Hyper POTS question

[Viktor]

Hi. Could these readings be considered pots based on this measuring that I have just done? Before I never measured my BP and heart rate in different position. Always measured it in sitting pose. But tried this now and here is the results. But be aware that I am taking beta-blocker bisoprolol 2,5 mg every morning. 

Here is the results, so you can see that HR stays almost the same and only the blood pressure changes, mostly diastolic :

Lying position
BP 110/64
HR 70

Sitting position
BP 126/94
HR 69

Standing position
BP 132/91
HR 81

Measured today, I have day off at work, so feeling good. Probably need to measure also in one of the bad days. 

Also I heard that BP/HR measurings are not enough and serum test for norepinephrine levels has to be taken as well to diagnose, right? 

[Pistol]

Hello @Viktor - POTS is generally diagnosed by an increase in HR of 30 BPM or more ( or above 120 BPM ) within 10 minutes of standing, without s considerable DROP in BP. HPOTS can cause increase in BP upon standing - but there are other conditions that can do that too. Considering that you are taking a beta blocker it may affect your HR. You really should take these readings to your GP or other treating physician b/c this forum is not able to read these results. 

HPOTS often gets diagnosed with serum norepinephrine levels but I don;t think that this test is mandatory for diagnosis. 

[Viktor]

Ok, thank you. 

[Viktor]

I just thought that it's not necessarily may be hyper pots, but orthostatic hypertension maybe as well. Or both. I have just measured it again today:

Lying: 110/65

Standing: 141/90

And its on a beta-blocker

So definitely have to go to the GP and see what is going on, but unfortunately it's impossible during covid. 

[Pistol]

Hello @Viktor - since I have HPOTS I used to suffer from orthostatic hypertension, and a beta blocker was not the med to control this for me ( it did however work for the tachycardia ). For many patients with this symptoms a calcium channel blocker or Clonidine can help patients with HPOTS related hypertension.  I would see the GP and ask for another ( or additional ) med to help control your hypertension. 

[Viktor]

Thanks Pistol. It could be that I have both of them.  Will try to call to GP again and beg again for the TTT referral. 

[Viktor]

One more question. I didn't find anything in the Internet on how orthostatic hypertension diagnosed. It says it's increase of the blood pressure by 20 upon standing, but doesn't say from which position. Is it from lying to standing, or from sitting to standing. Because its seems like I have significant increase from lying to standing, and only small from sitting to standing

[Pistol]

Hello @Viktor - here is a video that explains how to take orthostatic vital signs. Usually it is the rise of BP from lying to standing ( but need to take sitting as well ), so you would note the increase when standing. 

https://www.bing.com/videos/search?q=how+to+take+orthostatic+vitals&docid=608033112828086457&mid=79524DB15336D7B5D79D79524DB15336D7B5D79D&view=detail&FORM=VIRE