Orthostatic hypertension?

[SystolicSyster]

This might be a long shot, since I'm not finding a lot of information about this online in general, but I'm wondering if anyone has anything to tell me about this? Has anyone had it, and if so, have you found out what caused it, or found a way to fix it?

I've only just had the lying/standing BP test, and missed seeing exactly how much my blood pressure shot up while standing up, but it was enough to make the nurse get a bit weirded out. The reason I had the test in the first place was that I keep getting a headache and a "weird feeling" in my head when I stand. I'll see the GP again next week, but I'm feeling so clueless, I thought I'd ask, just in case anyone knows anything about this.

The only tenuous relevant explanation I can find by google is that it might have a link to SNRIs, and I'm on Mirtazapine. Just a random mention somewhere online, though. The medication leaflet only mentions orthostatic hyPOtension as a side effect. I really hope I don't have to stop the medication for this reason, as it's been really helpful, unlike the SSRIs I tried in the past.

I guess no one here, either.

This is a bit of a weird one. The reason why there's not much online is that it's caused by lots of different things, the most common one being high blood pressure in general. Can I just ask, were they monitoring your HR as well as your BP, as orthostatic hypertension can be linked to POTS (high HR on standing), especially if-slightly oddly-you are on a lowish salt diet and tend not to drink enough water. Basically there's not enough blood in circulation, so when you stand up it all pools in your legs and so your autonomic nervous system increases BP to push it back up the body so the brain gets enough oxygen.
Also it can be linked to Diabetes so that might be worth checking out too.
Are they going to refer to cardio?

Thanks so much for answering!

They were trying to listen to the HR, but only with a stethoscope, and said it became very hard to hear when I stood up (while had been fine when I was lying down). I didn't "feel" tachycardic, if that makes sense. I can usually feel my own heart beat, and it seemed fine at the time. I know that's not the most reliable way of measuring it, though!

I'm not on a low salt diet, as my BP has always been fine in the past (when measured sitting down in the normal way). Oddly enough, my massage therapist keeps telling me I'm dehydrated for some reason, but i drink and pee all the time, so haven't been putting too much thought to that. I've had blood sugars tested many times in the past and even monitored them myself at one point, and so far no one's told me I have diabetes. I am wondering again, though. I have PCOS and I'm overweight, so it's clearly a risk. (This has definitely scared me back onto healthier eating...)

I don't know if I'll be referred anywhere. I had a bunch of bloods taken last week, and when I called back to ask about results, was told that "most of them are fine, but the GP wants to see you", so I guess I'll have to wait until I see her tomorrow. (I'll also be filling in the form that my surgery requires before they let you see your own results online!)

It's very difficult for the body to take up liquid into the cells without adequate electrolytes so you could be dehydrated even though you're drinking plenty. I would try adding some more salt to your diet or maybe drinking some electrolyte solution (you can get fizzy tablets from sports shops in different flavours.) to see if that helps things. Good luck with the doctor.

I'll give some rehydration sachets a go, thanks.

GP wasn't actually super worried about the orthostatic side of things, but does want me to home monitor BP for a while, as it seems it's risen in general of late, with a view of "must do something about it" if it's consistently high. She's referring me for some weight loss support, which can't be a bad idea...

It seems the OHT is not my main problem at the moment, after all. Not severe enough to be the cause of headaches, and nothing to do with the blood test results. Will need more bloods and probably a scan. Oh well.

I would take advice about fluid & electrolyte management from an HCP who actually understands the physiology properly & knows what your blood results and actual BP readings are. (The above responder seems a bit muddled about intravascular vs intracellular fluid control).

My GP seemed really much more focused on monitoring BP, potential meds (and/or review of other meds I take), healthy food, avoiding alcohol etc than electrolytes tbh. I've bought some coconut water, and assume a glass of that here and there won't hurt.

Hi @SystolicSyster I hope you're doing ok. Could I ask if you ever found the cause of this? I struggle with it too

Hi @showslope - I happened to notice the "you've been mentioned"! I'm sorry you're having this nuisance.

I think mine ended up being filed under the "caused by high blood pressure in general". I had various tests done, including a brain scan (MRI?) because of the pain and weird feeling in my head, and came out very reassured that there wasn't anything concerning going on. No diabetes or any other issues with bloods, either. A low dose of ramipril actually stabilised my BP really well, where it stopped doing the very high spikes.

That didn't actually fix the pain/feeling in my head, so I've been assuming that for me the two are separate things. It's kind of been left without any specific explanation, but since a low dose of amitriptyline knocked those off, I guess migraine-ish? They come back when I quit the amitriptyline, too. (I'm just currently once again weighing which is the bigger annoyance for me.)

As a side note, this whole thing gave me a kick up the backside about my lifestyle, and I lost weight, started exercising five times a week, changed my diet, and completely stopped drinking alcohol (not all in one day!) - but while that's all been great for me, it's the ramipril keeping my BP steady, annoyingly. Without it, I still start going all over the place.