Low Pulse Pressure

[Machair]

Getting up in the morning has improved thanks to some very helpful advice I have received from this forum regarding fluids and other POTS self help measures- Thank you.

What I have noticed, though, apart from the rise in pulse on standing, is this incredibly low pulse pressure - that is the difference between the BP figures. This morning it was only 90/75 and that is after several error readings, and this is the norm for me when I stand - no wonder I get dizzy at times!This is consistent with the readings DR Bell talks about in his ME/CFS patients so I was wondering is this your experience?

My theory is that there can be hardly any blood going round - no wonder fluids are required after a night in bed!

It does improve during the day but not to normal levels by any means.

Anyone else with these low pulse pressure readings?

 

[glenp]

Yes, this is common. Nine was 77/44 in the cardiologist's office, he thought his monitor was malfunctiining!!!
"
It sounds like you have more then POTS. If you search " dysautonomia " you will find other distubances besides pots.

There is lots of information on dysautonomia on the forums here.

glen

 

[helsbells]

I tend to the opposite get high PP as if one chamber pumps out quicker than other one pumps in (or the other way round sorry its early) I also note this can may be feel more peculier than straight forwardly high or low blow pressure. I too am diagnosed with dysautonomia.

 

[rifyraina]

In fact, your blood pressure readings are all well within the range of normal. The fact that your pressure drops on standing is not at all unusual, and may be due to an benign phenomenon known as orthostatic hypotension (but very, very mild) or could be just because you don't wait a full minute after standing (as per medical protocol) to take your standing pressure. Your heart requires a minute at least to adjust to the change in posture.

 

[CBS]

In fact, your blood pressure readings are all well within the range of normal. The fact that your pressure drops on standing is not at all unusual, and may be due to an benign phenomenon known as orthostatic hypotension (but very, very mild) or could be just because you don't wait a full minute after standing (as per medical protocol) to take your standing pressure. Your heart requires a minute at least to adjust to the change in posture.

rifyraina,

Are you suggesting that a pulse pressure of 15 is normal (90-75)? A pulse pressure of 40 is normal and a deviation in pulse pressure of 5-10 can be significant. Neither the 90 nor the 75 on it's own is anything to get excited about, especially when considering a a single reading but together they are not where things ought to be. Postural orthostatic tachycardia syndrome (POTS - primarily characterized by a significant rise in HR upon standing) can be associated with a drop in BP and is a huge deal with many CFS patients. POTS (possibly due to an autonomic issue) combined with low blood volume is not" benign." Other cardiovascular issues impacting BR and HR are quite common (many related to autonomic dysfunction).

Machair - I'd suggest taking a look at one of Dr. Klimas' discussions where she discussed the frequent issues CFS patients have with low blood volume. Let us know if you need help finding one on the forums.

Here's a quote from a presentation she gave in November, 2009:

Question: When I fly from north to south, it seems that I really crash afterwords, I find it really hard to recover from that.

Nancy Klimas: You guys are about a litre short in blood volume, ok? If I’m sitting at five litres, you’re sitting at four. So, you’re really, really sensitive to blood volume changes. If you’re a little dry, you crash. You’ve got to hydrate so aggressively when you’re in dry areas.

Transcripts of her presentation can be found here:
http://aboutmecfs.org/Rsrch/XMRVKlimas.aspx
http://aboutmecfs.org/Rsrch/XMRVKlimasII.aspx

Here is a link to the videos of her presentation: http://cfsknowledgecenter.ning.com/video (you'll need to create an account to view these).

 

[ahimsa]

Are you suggesting that a pulse pressure of 15 is normal (90-75)? A pulse pressure of 40 is normal and a deviation in pulse pressure of 5-10 can be significant.

Yeah, I completely agree with you that 15 is not normal. Back when I was young and healthy I used to donate blood on a regular basis. The blood donation folks would not take blood from anyone who had a pulse pressure less than 25. I remember that number because mine was often right on the edge (e.g., BP of 91/65) but it was always at least 25.

Anyway, my point is that one does not have to be a medical expert to know that pulse pressure less than 25 could be an indication of a problem. I'm a bit surprised by rifyraina's comment that everything is just fine.

Update - I meant to include a link for information about POTS (in case you haven't already seen it) - http://www.dinet.org/ And like CBS said there is also lots of information in these forums.

 

[Machair]

CBS

Thank you so much for your reply. Yes I know that 15 is not normal. I am a trained nurse so this is what I already knew, but was really seeking to find others with a similar clinical presentation.I have POTS and OI, but it was really the pulse pressure that worried me, but I think the low blood volume is a major part of it. Thank you so much for the link to the Nancy Klimas discussion, it backs up the work of Dr Bell and his findings about low blood volume doesn't it? It explains why I am so much worse in heat too and when I fly south. I have been helping myself by drinking coconut water, which has been very effective at controlling dehydration. I have been having Vita-Coco which you can get in The States, we just have it now in England and it is full of electrolytes. I am trying to beat this problem as I want to visit my son who lives in Arizona soon and it's pretty hot there I know.

 

[kerrilyn]

I've done quite a bit of reading about POTS and OI and all that fun stuff, and read about low blood volume as a possible cause but I haven't seen how you would know. How does someone find out if they have low blood volume? Is there a specific test?

I just got a dysautonomia dx after a TTT test and the doc said I need more fluids and salt so that would coincide with increasing blood volume (he mention low blood pressure). I think he said something about it, but I was too sick after the test to care to question anything. You can't know if someone has low blood volume from TTT testing can you? They did take blood to test certain things.

 

[SteveRacer]

I have a low BP, partly due to genes, plus from all the cardio I was doing before this started... but even though the reading is low, many times my heart will feel like it is pounding like a hammer.

 

[jamesrayenz]

There situations in which there is a big diffrence between systolic and diastolic pressure, the aortic regurgitation associated peripheral such cases you have to sign, one more thing that your blood pressure (Blood Presure) than usual, it's fantastic.

 

[Valentijn]

In fact, your blood pressure readings are all well within the range of normal. The fact that your pressure drops on standing is not at all unusual, and may be due to an benign phenomenon known as orthostatic hypotension (but very, very mild) or could be just because you don't wait a full minute after standing (as per medical protocol) to take your standing pressure. Your heart requires a minute at least to adjust to the change in posture.

How odd. While searching for "low pressure pulse" on google I found exactly the same statement on a board from 2008 at http://www.doctorslounge.com/cardiology/forums/backup/topic-22193.html , which has literally been cut-and-pasted to here. Also with idiots (a CNA and a doctor in that case) asserting that a 15 pulse pressure is nothing to worry about (because only an expert can take BP or something and mere mortals and electronic devices are unreliable)

 

[Sushi]

I've done quite a bit of reading about POTS and OI and all that fun stuff, and read about low blood volume as a possible cause but I haven't seen how you would know. How does someone find out if they have low blood volume? Is there a specific test?

I just got a dysautonomia dx after a TTT test and the doc said I need more fluids and salt so that would coincide with increasing blood volume (he mention low blood pressure). I think he said something about it, but I was too sick after the test to care to question anything. You can't know if someone has low blood volume from TTT testing can you? They did take blood to test certain things.

Hi Kerrilyn,

If the TTT is read by a doctor who know the autonomic nervous system well and all the elements of the TTT are done, you can gauge blood volume--at least my TTT report did.

There are specific tests for blood volume. I don't remember them at the moment because I never had one but do know patients who have. You can probably find the tests on POTSplace.com.

I also had a low pulse pressure on the TTT--88 over 80, if I remember correctly.

Sorry I don't remember the details of the blood volume test.

Sushi