Pulse Pressure

[angelloz]

Hello all, I am finding on my worst days I have low pulse pressure. I have checked my BP machine at the doctors and it is accurate. One day I felt so badly I called the nurse with a pulse pressure of 11...she told me it couldn't be that low. When I research low pulse pressure it doesn't mention dysautonomia...only other severe aliments. Does anyone else have this issue? What is the cause? Do I treat it like low BP with fluids etc? Sigh.....

[Guest KiminOrlando]

Do you mean the spread between the two numbers in your BP? Mine is that low but I was told it was no big deal. Now I'm curious. 

[RecipeForDisaster]

I find that low pulse pressure correlates with how badly I’m doing, but I don’t see a lot of people interested in it.

[RecipeForDisaster]

Oh, and this is greatly improved with IV fluids...

[toomanyproblems]

If you search there have been a number of times this has been brought up over the years if you'd like more responses. Personally, my pulse pressure frequently becomes very narrow.  Twelve is the worst mine has been that I can remember rn but my BP was 52/40 at the time so things weren't going well in general. But I can have a pulse pressure of 20 daily at various times over the day. I've had one that was 100/82 the dr's office even, and mentioned it to the nurse, who repeated it but was not alarmed. I think it's a thing for many POTS patients, but I don't think there are many medical staff educated about what it actually means.

[Pistol]

Hi @angelloz I found the following statement : 

A pulse pressure narrower than 20 is an indicator of poor heart function. Many people with POTS report that pulse pressure is a better indicator of how they feel than is blood pressure or even heart rate. Narrow pulse pressure can be caused by congestive heart failure, cardiac tamponade, or hypovolemic shock

It is from this article: https://potsspot.wordpress.com/2015/12/11/pots-and-pulse-pressure/#:~:text=A pulse pressure narrower than 20 is an,congestive heart failure%2C cardiac tamponade%2C or hypovolemic shock.

I personally experience low PP ( along with diastolic hypertension ) whenever in a flare. I feel really bad then, with chest pain, palpitations, shortness of breath and dizziness. For the past 2 years I have been getting IV fluids a few times a week and the flares as well as the BP and PP instability have greatly improved. I think the low PP has to do with abnormal vasoconstriction or dilation - this would cause the heart to pump harder and faster, therefore increasing the force with which the heart has to beat in order to provide adequate circulation. As I mentioned - IV fluids can ( and in my case do ) counteract this by providing and increase in vlume and even pressure within the blood vessels. 

[cmep37]

Mine was 14 this morning!  Mind you I felt awful, my BP was 84/70 and my HR 149 BPM.  It's never more than 25 when I'm standing and I find the lower it is is a better indicator of how bad I feel than HR - sometimes my HR can be 130ish (which is good for me) but I'll feel worse than when it's 140ish (which is more normal) if my pulse pressure is less than 20.    My GP doesn't like it - her advice is to lie down and drink a litre of water if it gets below 20 which usually helps a bit.