Increased blood pressure during poor man's TTT

[Scarecrow]

I've been looking for a thread I was sure was on here. Somebody had posted a matrix with various b.p. and heart responses during tilt table testing with an analysis of the combinations. If anyone knows the thread I'm thinking off and can point me in the right direction I'd appreciate it.

Meanwhile, here are the results of a test I did a few days ago. Rather than a standing test, I had my shoulders against the wall with my heels about a foot away from the skirting. Does anyone know what to make of the increase in my blood pressure as my heart rate increases?

Time HR sys dia

-2 mins 62 110 67

-1 min 62 112 72

0 mins 75 106 76

+2 mins 75 112 76

+4 mins 82 125 87

+6 mins 86 119 87

+8 mins 93 129 89

+10 mins 96 134 90

Sorry, formatting is rubbish (but looks fine on edit). I've tried a few ways to sort it but no luck.

 

[minkeygirl]

Do a search for POTS or OI. You may find something there.

 

[Scarecrow]

Do a search for POTS or OI. You may find something there.

Thanks, minkeygirl. I've already searched exhaustively. Just can't find what I'm looking for. It may what I'm thinking of wasn't on a thread. Could just have been something I googled somewhere else.

 

[minkeygirl]

I'm trying to think who to tag who could help you but my brain isn't working today. Maybe @Sushi will know.

 

[Sushi]

I'm trying to think who to tag who could help you but my brain isn't working today. Maybe @Sushi will know.

I don't know but @Valentijn might know where the

matrix with various b.p. and heart responses during tilt table testing with an analysis of the combinations.

was posted.

Sushi

 

[Valentijn]

@Scarecrow - There's probably several threads with other people's data.

Regarding your own results, you probably need to stand up without leaning on anything for useful readings.

 

[SOC]

@Scarecrow
Are you thinking of this from here?

Results

Below is a listing of the abnormalities observed and the normal values taken from Dr. David Streeten’s book Orthostatic Disorders of the Circulation.

Normal Test Results

• Systolic Blood Pressure (top number): recumbent: 100-142; Standing (4 min): 94-141; Orthostatic change: -19 to +11
• Diastolic Blood Pressure (bottom number): recumbent: 55-90; Standing: 61-97; Orthostatic change: -9 to +22
• Pulse: recumbent: 54-96; Standing: 62-108; Orthostatic change: -6 to +27

Indications of orthostatic intolerance

• Orthostatic systolic hypotension (low blood pressure): fall in systolic blood pressure of 20 mmHg or more
• Orthostatic diastolic hypotension (low blood pressure): fall in diastolic BP of 10 mm Hg or more.
• Orthostatic diastolic hypertension (high blood pressure): rise in diastolic BP to 98 mm Hg or higher
• Orthostatic narrowing of pulse pressure: reduction in pulse pressure to 18 mm Hg or lower.
• Orthostatic postural tachycardia (increased heart rate): increase in heart rate of 28 bpm or to greater than 110 b/min.

 

[SOC]

@Scarecrow -
Regarding your own results, you probably need to stand up without leaning on anything for useful readings.

@Scarecrow
You may also need to stand longer. Sometimes it takes longer than 10 mins to see the full effect. Notice that Dr Bell's test takes 45 mins.

 

[Kati]

The raise in blood pressure is seen in POTS along with tachycardia, and is a response from the autonomous nervous system

Doing a poor man tilt table, try it the very first thing in the morning, off the wall and try to move as little as possible. When i did this in preparation for Dr klimas's visit she asked to do this 7days in a row.

 

[Scarecrow]

@Scarecrow
Are you thinking of this from here?

Thanks, @SOC. That's the one. And thanks to everyone else who replied.

The raise in blood pressure is seen in POTS along with tachycardia, and is a response from the autonomous nervous system

It's interesting that you should confirm this, @Kati; you've dealt with my reason for posting. I knew that one of the criteria for POTS was an increase in heart rate of >=30 b.p.m. but I've never seen anyone mention increased blood pressure and I did search on here, honest! Also, all of the POTS websites I've visited emphasise hypotension.

It's been a long, LONG time (more than 20 years) since I've had to sit on the pavement because I couldn't stand any longer. In recent years (the last four) lurking around here I've come to realise that I've had some sort of OI problem since sometime post IBS, during the gradual decline but before the 'falling off a cliff' M.E. happened.

I discounted POTS. I've never thought to pursue the OI side of M.E. because my G.P. would only have rolled her eyes at me ..... again....... and to be honest I only considered myself to be mildly affected by whatever OI issue I had.

When I did tell my doctor that I had come close to fainting several times while shopping, she dismissed me saying that it was just 'healthy low blood pressure' and that she got dizzy sometimes too when she stood up. right back at you, doctor.

To answer all your points about doing the poor man's TTT standing up, that's the reason I dismissed the possibility of POTS. My heart rate just yoyos up and down no matter how long I stand. The reason I tried the wall tilt is because of the stuff from Julia Newton that's been posted recently. She suggests that people can improve their POTS by tilting against the wall for as long as they can manage each day. I suppose it's a way of training the ANS.

My thinking was well if the actual tilt of the tilt table is important, and it clearly is, perhaps that would be a more accurate poor man's method. So I tried it out of curiosity.

I wonder if the increased blood pressure is the reason the +30 b.p.m. doesn't show up when I stand upright, i.e. the blood pressure increasing means the heart doesn't need to beat as fast.

 

[Kati]

Yes, it's an attempt to compensate.
When I first did my 7days of poor man tilt table test, the first attempt, i pretty much passed out but the other times were fine, just heart rate increase and BP, somewhat.

However it was through getting a real tilt table that things got confirmed, and quite honestly who does them matters, especially in the light of understanding that ME patients need to be tilted longer because of the delayed onset of POTs in our population. i also had a local autonomic dr doing a tilt test by having me simply standing by myself which is not acceptable ( he mostly works with spinal cord injury patients, and his "table" basically was a sitting table, not full body tilt). On a real TTT you are not supposed to move at all when you are tilted, for the whole time because moving can contribute to accomodating or 'helping your body'. For instance, if you have to stand up in a line up, and you're not feeling too good, people will switch weight bearing from one leg to another, or crouch or cross the legs and squeeze. These are all behaviors that helps blood return to the heart.

Dr Klimas started me on low dose Atenolol (12.5 mg BID) and florinef. I am no longer on florinef but the Atenolol stays, and I can't say I feel much better while on it but I notice I am doing much worse when i'm off it. (I hope it makes sense.

On the tilt table test my BP went as high as 150/100 when my normal would be 100-110/60-70.

 

[Marky90]

I have the same issues (confirmed via a cardiologist). He didnt think the high blood pressure caused the near-faint feeling and lightheadedness, and he didnt think it was due to low blood volume (because he checked the oxygen levels in my blood in my fingers..). I didnt really understand why it couldnt be low blood volume though. He thought it was due to adrenalin issues, so were checking that up. He advised me to go to an endocrinologist.