orthostatic hypertension - how do you deal with this?

[Likethecolorblue]

I have ortho. hypertension and my bp drops about 20 systolic from lying down (say 120), to sitting (100) and standing 80. This effects my heart rate from low to high. When standing, I am too dizzy to walk so obviously can not get the excersize I need. Take Eliquis for AFIB. Any suggestions.

[Happyrosie]

I don’t know, but I looked up the condition on the UK’s National Health System website. US nomenclature is often different from ours in the UK, so what I got may not be what you want, but here it is in the hope that it’s helpful.

This does not come out very well in this post with no spacing etc so please Google NHS and then orthostatic hypertension in the search box.

Postural tachycardia syndrome (PoTS)Postural tachycardia syndrome (PoTS) is an abnormal increase in heart rate that occurs after sitting up or standing. Some typical symptoms include dizziness and fainting.It's sometimes known as postural orthostatic tachycardia syndrome.PoTS affects a range of people but is most common in girls and women aged 15 to 50.Some people have mild symptoms, while others find the condition affects their quality of life. PoTS often improves gradually over time, and there are some medicines and self-care measures that can help.What happens in PoTSNormally when you sit up or stand, gravity pulls some of your blood down to your belly area, hands and feet.In response, your blood vessels quickly narrow and your heart rate increases slightly to maintain blood flow to the heart and brain, and prevent blood pressure dropping.This is all done without needing to think about it, by the autonomic nervous system – the nervous system in charge of automatic body functions.In PoTS, the autonomic nervous system does not work properly. There's a drop in blood supply to the heart and brain when you become upright and the heart races to compensate for this.Symptoms of PoTSYou can develop PoTS suddenly, or it can begin gradually.You can sometimes get symptoms almost immediately, or a few minutes after sitting up or standing. Lying down may relieve some of the symptoms.Typical symptoms of PoTS include:dizziness or lightheadednessfaintingproblems with thinking, memory and concentration – this combination of symptoms is often called "brain fog"heart palpitationsshaking and sweatingweakness and fatigue (tiredness)headachespoor sleepchest painfeeling sickshortness of breathSome people notice that feeling hot, eating, strenuous exercise or having a period can make their symptoms worse.When to get medical adviceSee a GP if you think you have PoTS.The symptoms can have a number of causes, such as medicine or low blood pressure, so it's a good idea to get a proper diagnosis. Sometimes it can be misdiagnosed as anxiety or panic attacks.Some doctors may not be aware of PoTS, so it may help to print out this page and take it with you to your appointment. A GP will probably need to refer you to a specialist for tests (see below).PoTS UK (a charity for people affected by PoTS) has a list of doctors with an interest in PoTS that you can use to find a specialist near you. You cannot usually self-refer to these doctors, but you could discuss a referral with a GP.Tests for PoTSPoTS is diagnosed if your heart rate increases by 30 beats a minute (bpm) or more (40bpm in those aged 12 to 19) usually within 10 minutes of standing. This increase continues for more than 30 seconds and is accompanied by other symptoms of PoTS.You may have a range of tests to confirm a diagnosis and rule out other conditions, including:tilt table test – your heart rate and blood pressure are measured while you lie on a specially designed bed that can be titled upright. The measurements are taken several more times while the bed is slowly tilted into a more upright positionactive stand test – your heart rate and blood pressure are measured after lying down, immediately upon standing, then after 2, 5 and 10 minutesan electrocardiogram (ECG) – a test of your heart's electrical activityan echocardiogram – an ultrasound scan of your heart24-hour ambulatory blood pressure and heart rate monitoring – small devices attached to your belt take regular readings while you're doing normal activitiesblood tests – to test your kidney, liver and thyroid function, and measure blood count and your calcium and glucose levelsTreatments for PoTSSelf-care measures can sometimes help to reduce the symptoms of PoTS. If these do not work, you may need to take medicine.Treating an episodeIf you suddenly feel faint or dizzy, you can try countering the fall in blood flow by:lying down and, if you can, raising your legscrossing your legs in front of each other while standing, rocking up and down on your toes, clenching your buttocks and tummy muscles and/or clenching your fists if you're unable to lie downReducing your symptomsYou may be able to reduce your symptoms in the long term if you:drink plenty of fluids until your urine is pale yellowkeep active, but pace yourself and choose your exercise carefully – swimming, rowing, lower limb resistance training, walking, jogging and pilates can help you keep fit and build muscle (strong calf muscles should help pump blood back to your heart)elevate the head end of your bed, so you're not sleeping fully horizontaltry wearing support tights or other forms of compression clothing, to improve blood flow in your legsavoid long periods of standingrise slowly after lying down – sit for a while before standingavoid drinking lots of caffeine or alcoholinclude more salt in your diet, however this is not advisable if you have high blood pressure or kidney or heart disease, so ask your specialist firstFind out more from the charity Syncope Trust And Reflex anoxic Seizures (STARS) on diagnosis and management of PoTS, and PoTS UK about self-management programmes.MedicineThere's no single medicine used for treating PoTS, but your specialist might suggest trying:a beta blocker or ivabradine – which decreases the heart ratemidodrine – which narrows the blood vesselsfludrocortisone – which decreases the amount of sodium lost in your peea selective serotonin reuptake inhibitor (SSRIs) – a type of antidepressant that can affect how your nervous system worksCauses of PoTSSometimes the cause of the problem with the nervous system in people with PoTS is unknown.Teenagers will sometimes develop PoTS and find it gradually disappears a few years later. Sometimes it can develop suddenly after a viral illness or traumatic event, or during or after pregnancy.Some of the other known causes are:hypermobile Ehlers-Danlos syndromeother underlying conditions – such as diabetes, amyloidosis, sarcoidosis, lupus, Sjögren's syndrome or cancerpoisoning – with alcohol or certain metalsinheriting a faulty gene that causes too much of the "fight or flight" hormone noradrenaline to be producedPoTS also happens quite commonly alongside chronic fatigue syndrome.More information and adviceThe following organisations can provide more information, support and advice for people with PoTS:POTS UKSTARS

[Likethecolorblue in reply to Happyrosie]

Thank you so much! I will print this out and read more carefully. I have had this for several years and have been to several kinds of doctors and never have they checked my bp while lying down, sitting and standing. I finally found info on the internet, but will take this to my gp and see if he can refer me to the right specialist. Hope you have a blessed day and you just don't know how much I appreciate your response.