Why have i never heard of low/narrow pulse pressure before?


Senior Member
I wouldn't dare take my BP while standing!

My pulse pressure is low too. Usually about 25 - 30.

What is the poor man's tilt test?
For me, I know exactly what will happen if you tilt me so I don't want to do that at a doc's office. Or anywhere. Just curious.


Moderation Resource Albuquerque
What is the poor man's tilt test?
For me, I know exactly what will happen if you tilt me so I don't want to do that at a doc's office. Or anywhere. Just curious.
A poor man’s tilt is a simple procedure you can do at home. There are a few versions but basically you lie flat for about 20 minutes then record your BP and pulse; do the same after a period of sitting and then standing (arm supported at heart level) every one or two minutes (as fast as you can do it) for 10 or 15 minutes.

The formal TTT straps you to a gurney and tilts you (head up) 80 degrees.
Weirdly, at my tilt table test in 2014, I did have just POTS, with an increase in blood pressure if I'm remembering correctly. They stopped it after twelve minutes. Pulse increased 64 beats. From my own testing over the years I can now see that was definitely an anomaly with the BP. Usually BP drops quickly. Figured out how to enter date and time and I tried this morning and got a bunch of error messages by the end, so I think when the pulse pressure gets lower than 12mmHg I can't even tell!

During the tilt, they did do my resting and elevated norepinephrine, I think at 2, 5 and 10 minutes of being tilted, and I was borderline "hyperadrenergic".

I have tried Ivabradine and Midodrine, and my standing pulse did decrease, as did my resting pulse I felt, and the fatigue was no better, possibly worse - I wasn't checking BP because of all the error messages. Currently taking a small dose of florinef (01.mg). I usually feel much worse in the morning, better by the afternoon.

Things I wonder about:
I've read about Marfan Syndrome and orthostatic intolerance in relation to tall stature, so I wonder if the same thing is happening (pretty tall at 6').
https://pubmed.ncbi.nlm.nih.gov/185...static tolerance are significantly correlated.

If my resting BP is normal does that show I can't just be dehydrated? I do think I'm hypovolemic, though.

Could a pacemaker help with dizziness and energy if I always have bradycardia at rest and this is not caused by being "super fit"?

I've also wondered about spinal fluid leaks, I watched a webinar with Dr. Ian Carroll out of Stanford where he talks about CSF leaks and mentions tall people with heritable connective tissue disorders.


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I just looked at my norepinephrine levels during the tilt table test...they tested once lying down (normal) and standing twice (high)...not sure how norepinephrine and pulse pressure are related...
Also my alpha sensitivity was found to be decreased.

"Norepinephrine induced a significant increase of cardiac output and a significant decrease of pulse pressure variation and systolic pressure variation but did not significantly change right atrial pressure or pulmonary artery occlusion pressure values."
https://pubmed.ncbi.nlm.nih.gov/162...se,pulmonary artery occlusion pressure values.


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