Hypertension/Postural Hypotension

[Auntielala]

Has anyone any experience of dealing with hypertension/postural hypotension please?

I seem to be going around in circles. I was on Bisoprolol 1.25mg for tachycardia for several years, then hypertension started and we added in Amlodipine 5mg. All was fairly well until 18 months ago, BP going higher and diagnosed with postural hypotension. It seems the higher my BP goes, the bigger the drop on standing from sitting/lying down, usually between 20-30. Since then we've tried different doses of Bisoprolol, dropping Amlodipine, adding Ramipril, didn't get on with that, back to just Bisoprolol again. Yesterday we decided on going back to Amlodipine 5mg and Bisoprolol 2.5mg combo, after BP readings in 190's systolic, low 100's diastolic, so back to the start again. Also starting me on Atorvastatin as cholesterol 6.54.

Has anyone found a successful regime for dealing with high BP with postural drop?

And is a statin really necessary for 6.54? I probably should add I'm on long term hormone blockers following cancer, and hypertension and raised cholesterol are listed as side effects, just to complicate matters.

Thank you if you can help.

[Beta70]

Hi AuntieLala, I was very interested to read your post as it sounds possible you have many of the same symptoms I do. I have high blood pressure which drops on standing from sitting or lying down to over 20. This causes me serious dizzy spells when I feel like I am going to pass out. I particularly suffer from this when getting out of bed in the morning and when rising from a chair after watching tv. My GP said it was something called Postural Orthostatic Tachycardia Syndrome and prescribed me some anti sickness tablets for the dizziness. I have never heard of this condition and there are some useful you tubes by Dr Sanjay Gupta about it. I do not take any of the meds you describe apart from Atorvastatin as I also have high cholesterol. I find this condition quite difficult to manage and my GP advised me to take a walking stick when I go out! I have only fallen a few times and walk along walls and sideways downstairs against the wall in the mornings now when I get up. I also get it when turning over in bed at night which disturbs my sleep. I have had 14 blood tests and all are ok as well as liver and kidney functioning, only cholesterol is high. It only started in October last year but apparently it is not life threatening which is really good news. I find some days better than others especially if I have slept well. Fortunately I am retired so can rest when necessary but I do find it exhausting. Best wishes.

[Auntielala in reply to Beta70]

Hello, and thank you for responding, although I'm sorry to hear you suffer from this too. Yes, that's it, I couldn't remember the full name, postural orthostatic tachycardia - when I stand up as well as the drop in BP, my heart rate goes up to around 112 temporarily. It doesn't get too high because of the Bisoprolol. I've had a few tumbles because of the wooziness. I've an appointment with the nurse next week to be fitted for compression stockings, the GP thinks they might help to stop the blood from pooling in the legs, has your GP suggested trying them? I said to the GP "thanks, I'm 70 in a few weeks and you're giving me granny stockings", but if they help to prevent the dizziness, that would be great. Some of the advice has been to keep well hydrated, avoid alcohol, eat small meals regularly rather than big meals, and the dreaded stockings, but nothing seems to work. Well, the stockings might help. At least we get good days/bad days so it's not all bad. Best wishes to you, and here's to hoping for more good days, and our doctors finding a solution, preferably drug-free, wouldn't that be nice? 🙂

[Beta70 in reply to Auntielala]

Yes I was fitted for the compression stockings but unfortunately found them really uncomfortable. However I did manage to purchase some bamboo compression long socks on e bay which I wear on long car or coach/train journeys and they definitely help. I am a year older than you. Yes I was advised to drink as much water as possible and avoid carbonated drinks. However this has the side effect of requiring me to get up at least twice during the night, and I find getting up out of bed the hardest. Also I was advised to take more salt having had hardly any in my diet at all. I use sea salt now. I also take a magnesium glycinate supplement daily as recommended on one of the You Tube channels. Recent reports have suggested that POTS is a symptom of Long C and as I had the dreaded C in September think this is possibly the cause of mine, in which case I am hoping it will be temporary. Kind regards.

[Auntielala in reply to Beta70]

Thanks for the tip about the bamboo socks, that's something to try if I don't get on with the stockings. I hear you regarding drinking more and the problem with that at night. That would be so good, if this pesky condition is temporary after your Covid, really wish that for you. 🙂

[Judithdalston in reply to Beta70]

I seem to be in the Long Covid category…after over 3 years post infection got raised BP first ( May 2020), put on 5 BP drugs, and not really improved. Raised HR with tiny exertion eg brushing teeth, that for last year obviously is POTS, and still left breathless. Had two X-rays and ECGs, 1 heart ultrasound, LC Breathing Support programme, 1 useless phone consultation with cardio( he only wanted to change indapamide to Bendroflumethiazide which made me extremely dizzy for a month so reverted back) and Gp reluctant to refer me back again. For last 6 weeks I have tried DIY treatment… gone swimming/water aerobics 5 times a week, and found I can be active with no problems, whereas 30 mins shopping with a trolley has me heading back to the car to sit down! I also take nattokinase that LC research in South Africa shows reduces blood clots( for 6 weeks my BP did go down to that of a youngster!).

[Healthy65]

Sorry only getting back on board now after a PVI ablation and bereavement lost my mother then my twin after 6 hard months battle Anyways beware of the amlodipine when used with bisoprolol I was changed to Lercandipine instead however there are others that my suit your medical profile

It was a great result bp control much better especially surges damped down quite a bit

Amlodipine is widely known to cause that dip in bp and your GP can easily see reports on that.

You may get help from a chat with either pharmacist or GP given the POTS situation

Using a walking stick is a good idea to steady yourself but tackle the cause - change meds to get a better result I would suggest.

Hope this is useful

Best regards

[Auntielala in reply to Healthy65]

Hi, I'm so very sorry for your sad losses, what a very hard time for you, so I'm very grateful to you for taking the time to respond to my post. This is really useful information, thank you, it's something else that I could try, I will mention Lercandipine to my GP. The stroke consultant wrote to my GP saying he suspected Amlodipine to be the cause of the POTS, so they seem aware. I hope you are doing well after your ablation. Take care of yourself, you've been through a lot, and thank you.

[Judithdalston]

Hi Auntielala, i had interrogated the BHF forum for ‘hypo/ hyper tension’ and only got this one post…I had forgotten I had made a comment 3 months or so ago. But thought I should update here. I have since had a tilt table test and diagnosed not with POTS but postural hypotension; though I get the rising HR ( up 30. + beats ) the consultant thought this was due to body trying to compensate for BP dropping from hypertension on lying down to very low hypotension very noticeably after about 8 mins. I had had a rather dramatic faint outside Sainsbury’s the week before ( and vomited profusely afterwards). She didn’t like the 5 BP drugs prescribed post Covid so has currently removed the bisoprolol and shifted the amlodipine from am to pm, she has further alterations in mind, but she wants a 24 hour BP monitor done first having no idea what my BP does overnight. Unfortunately 2 weeks in to the new regime I feel worse, not surprisingly with resting HR too over 100, and feeling the palpitations! I have continued with many of the DIY recommended remedies like socks, swimming and was given a corset….

How you doing?