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Orthostatic Hypertension


Senior Member
Vermont, school in Western MA
@halcyon Originally it was thought with POTS that one had to have OH (orthostatic hypotension) too. They clearly are just defining it there to make it clear there that POTS isnt defined etc by having OH with it. In fact now if you have the OH with it as many do, you now get given two different diagnoses. One of POTS and one of orthostatic hypotension.

Lots of us here including myself have orthostatic hypertension. It's one of the 5 different kinds of dysautonomia that ME expert Dr David Bell says happens with ME. A ME person may have just one of these kinds to being like myself and having ALL of these so its quite possible to have both orthostatic hypertension and orthostatic hypotension (both when standing I can have 197/136 at one minute of standing or go to 40/0 (that's a lay NOW reading for me) with my BP readings. I never know what my BP and heart is going to do when I stand.

So be aware though orthostatic hypertension has been found for you, it is very possible you could also have other of the dysautonomia types too.

Im on clonidine for the orthostatic hypertension part of my POTS. Clonidine works differently to other high BP drugs as it works by helping keep the noradrenaline down which causes the BP spike in this kind of issue.

there has been a very good scientific article on this kind of POTS (if Im remembering correctly it was in some Indian Journal). Note this kind of POTS, when those who have this were studied, they found they were extremely likely to have a mast cell disorder (it was over 80% ..I cant remember how many now but it was extremely high, of those who have it have been found to have a mast cell disorder).
I'm wondering if guanfacine could help my medical ptsd and white coat hypertension. I feel awful w beta blockers but have never tried alpha agonists. I have such a fear of doctors that I don't go in even when I may be having a medical emergency. Gotta fix this. Also looking at prazosin or clonidine


Senior Member

I am new to this site and desperately looking for answers, my name is Jim and I am 44 years old. I do not really have a diagnosis yet but can tell you the millions of things I dont have. I feel like a laboratory test monkey for as many Dr's that I have seen. I started having chest pain in 2012 that would occur daily, I must have went to the ER no less than 20 times over the past 4 years and each time they found nothing that was wrong but yet I was having chest pain and felt an overall yuck feeling on a regular basis.

In 2013 the ER Dr found that when I stood up my Bp would go from 118/70 to 150/100, so I was seen at the University of Iowa for autonomic testing and told that there was nothing wrong with me and that I have hypertension. I was started on different meds over the years and ended up on lisinopril. The problem is that I do not need Bp control when I am sitting or lying down so my pressure drops and it becomes a crazy balancing act. I have been all over the internet for the past few years and this is the first site that talks about orthostatic hypertension. If anyone has any ideas please let me know. I am currently not taking any meds and my upright bp is high until i sit or lay down.
Have u found any help