For those with HyperPOTS, does both your systolic and diastolic bp increase when standing?

[Elizaangelica]

I know blood pressure increase is not the way that HyperPOTS is differentiated. I’m just curious about this because my diastolic (bottom number) always increases and my systolic (upper number) always decreases when I’m standing. I definitely relate far more to the HyperPOTS experience of the condition. Hormone testing to differentiate types doesn’t seem to be considered important here. My cardio wants me to keep increasing salt, but I don’t feel like it makes any difference at all.

[Pistol]

@Elizaangelica - I have HPOTS and my diastolic BP goes up a lot but the systolic not as much. For example I can easily go to 150/110 when standing ( this hardly ever happens anymore unless I am in a flare, thanks to regular IV fluids, meds and the fact that I am house bound ). I suffer from sympathetic overcompensation, which causes excessive adrenaline dumps leading to severe vasoconstriction, hence the diastolic hypertension. I was told that diastolic hypertension is common in HOTS. 

[toomanyproblems]

10 hours ago, Elizaangelica said:

I know blood pressure increase is not the way that HyperPOTS is differentiated. I’m just curious about this because my diastolic (bottom number) always increases and my systolic (upper number) always decreases when I’m standing. I definitely relate far more to the HyperPOTS experience of the condition. Hormone testing to differentiate types doesn’t seem to be considered important here. My cardio wants me to keep increasing salt, but I don’t feel like it makes any difference at all.

Actually, some docs do use increase in BP upon standing (along with greater than 30 BPM heart rate increase) as criteria for hyperPOTS.

Like Pistol, I can have increase in both systolic and diastolic but more so with diastolic as my pulse pressure becomes more narrow. But I have also had what you describe on occasion -- a decrease in systolic and increase in diastolic. And sometimes I have classic postural hypotension, usually at night. I've also been surprised to find myself blacking out from a rapid drop in systolic upon standing and narrowing of pulse pressure even when the numbers are not in the hypotensive range. 

It seems like some experts don't like to classify this disorder into types because of variability. For myself, over the years, I seem to have gone from always having orthostatic hypotension to usually having a BP increase of some sort upon standing. And even now, my body likes to mix it up some just for fun  

So I'm not sure how neatly most POTS people fit into the distinct type boxes as defined at the moment.

[Pistol]

12 hours ago, toomanyproblems said:

Actually, some docs do use increase in BP upon standing (along with greater than 30 BPM heart rate increase) as criteria for hyperPOTS.

I agree, @toomanyproblems. They use an increase of BP upon standing for HPOTS diagnosis b/c the increase of BP is a sign of high NE levels, and the high BP is what differentiates HPOTS from other types of POTS. 

 

 

[dlgrn715]

On 6/23/2021 at 8:10 PM, Elizaangelica said:

I know blood pressure increase is not the way that HyperPOTS is differentiated. I’m just curious about this because my diastolic (bottom number) always increases and my systolic (upper number) always decreases when I’m standing. I definitely relate far more to the HyperPOTS experience of the condition. Hormone testing to differentiate types doesn’t seem to be considered important here. My cardio wants me to keep increasing salt, but I don’t feel like it makes any difference at all.

 

[dlgrn715]

Not able to answer your specific question, but thought this info might ease your mind: In general, the diastolic blood pressure is not as significant as the systolic unless it is around 90 or above and sustains at a high number. 80 and below is normal. See link to article

https://www.webmd.com/hypertension-high-blood-pressure/guide/diastolic-and-systolic-blood-pressure-know-your-numbers

[p8d]

I asked one of my Drs, probably cardiologist but can’t remember, about high >90 diastolic and systolic not overly high and was told it’s often related to hypovolemia. I have experimented on myself and if I drink a glass of fluids fairly quickly the diastolic does come down but the systolic goes up too.