A woman experiences rapid heart rate as a symptom of blood pressure fluctuation in POTS.

Managing Blood Pressure Fluctuations in POTS: Tips and Strategies

Understanding these changes and monitoring symptoms can help you regain balance and control.

Imagine standing up to grab a glass of water, only to feel your heart race, your head spin, and your energy drain in an instant. For those living with Postural Orthostatic Tachycardia Syndrome (POTS), this can be a daily challenge.

Blood pressure fluctuations are a hallmark symptom of POTS, and they can turn simple tasks into overwhelming hurdles. But here’s the good news: understanding what causes these fluctuations and learning how to manage them can make a world of difference.

Essential Takeaways:
  • Blood Pressure Fluctuations Can Be Debilitating: In POTS, the autonomic nervous system struggles to regulate blood pressure, leading to dramatic highs and lows that can cause dizziness, fatigue, and even fainting. These fluctuations can disrupt daily life and make routine tasks feel impossible.

 

  • Effective Management Can Restore Balance: By combining lifestyle adjustments, like staying adequately hydrated and wearing compression garments, with tools like blood pressure monitoring and tailored medical treatments, you can reduce these fluctuations and regain a sense of stability and control.

In this guide, we’ll dive into the science behind POTS blood pressure changes, help you recognize the warning signs, and share actionable strategies to help you feel more in control of your body and your life.

What Causes Blood Pressure Fluctuations in POTS?

POTS is a condition that affects the autonomic nervous system, which controls involuntary processes such as heart rate and blood pressure. In people with POTS, the autonomic nervous system struggles to regulate blood pressure effectively, especially when you’re transitioning from sitting or lying down to standing.

Learning to identify what triggers blood pressure fluctuations in POTS can help you develop better management strategies.

Common Triggers

This can lead to a range of blood pressure-related symptoms. Common triggers of blood pressure fluctuations include:

  • Prolonged Standing: Standing for long periods can cause blood pooling in the legs, leading to hypotension.
  • Dehydration: Insufficient fluid intake exacerbates blood volume issues, increasing the risk of low blood pressure. Learn how to hydrate with POTS.
  • Changes in Body Position: Rapidly moving from lying down to standing can trigger orthostatic intolerance and cause blood pressure fluctuations.
  • Stress and Overexertion: Physical or emotional stress can lead to spikes in blood pressure.

Recognizing these triggers is a game-changer for managing blood pressure ups and downs with POTS. Once you know what sets off your symptoms, you can start making small changes that add up to a more balanced and steady day-to-day experience.

Did you know that certain exercises can help POTS symptoms over time? Find out more in our guide to Postural Training for POTS.

A woman drinks a glass of water with a squeeze of Buoy Hydration Drops to stay hydrated and manage blood sugar fluctuations in POTS.

Staying hydrated with electrolyte-rich beverages is a crucial step in managing POTS symptoms. Simple changes like adding Buoy’s Hydration Drops to your water can help maintain blood volume and improve circulation.

Recognizing Symptoms of Blood Pressure Changes

Understanding the symptoms of blood pressure fluctuations in POTS is essential for managing this complex condition. While POTS is often associated with low blood pressure (hypotension), some individuals may also experience episodes of high blood pressure (hypertension).

Learning to identify these symptoms early can help you take the necessary steps to regain balance and feel more in control.¹

Symptoms of Low Blood Pressure (Hypotension)

Low blood pressure episodes are common in POTS, especially after standing or during periods of dehydration. Symptoms may include:

  • Dizziness or Lightheadedness: Often experienced when transitioning from sitting or lying down to standing.
  • Fatigue: A persistent sense of tiredness or lack of energy that doesn't improve with rest.
  • Nausea: A queasy or unsettled feeling, sometimes accompanied by a loss of appetite.
  • Blurred Vision: Temporary vision disturbances due to inadequate blood flow to the brain.
  • Fainting: In severe cases, blood pressure drops can lead to syncope (passing out).

If you experience these symptoms regularly, it’s a clear sign that your body is struggling to regulate blood pressure. Taking proactive measures like staying hydrated, monitoring your posture, and seeking medical advice can help manage these episodes and improve your quality of life.²

Symptoms of High Blood Pressure (Hypertension)

While POTS hypotension (low blood pressure) is common, some patients may also experience POTS hypertension (high blood pressure) in certain situations, often in response to stress or overexertion. Symptoms may include:

  • Headaches: Pressure or pain, particularly at the back of the head.
  • Chest Tightness: A sensation of heaviness or discomfort in the chest area.
  • Flushing: Reddening of the face or upper body, often accompanied by warmth.
  • Rapid Heartbeat: A racing pulse that may feel out of sync with your physical activity level.³

Recognizing these symptoms and their patterns can make it easier to pinpoint triggers and take action to prevent severe fluctuations. By tuning into your body's signals and identifying whether you’re dealing with high or low blood pressure, you can better manage your day and reduce the impact of POTS on your daily life.

The next step is learning how to address these symptoms with targeted strategies for balance and relief.

POTS symptoms can vary greatly from one person to another. Get a comprehensive list of possible signs in our POTS Symptoms Checklist.

Medications That Can Help

When lifestyle changes aren’t enough, your doctor may prescribe medications to help manage POTS symptoms. Always consult with a healthcare provider before starting any new medication.

Common Medications

Treating blood pressure fluctuations in POTS often requires a personalised approach. In some cases, medication can provide additional support alongside lifestyle strategies. Commonly used medications include:

  • Fludrocortisone: Helps the body retain salt and water, boosting blood volume to support more stable blood pressure.
  • Midodrine: Raises blood pressure by constricting blood vessels and can help reduce orthostatic intolerance.¹ ²
  • Beta-Blockers (for a specific subset of POTS): Used in certain cases where postural tachycardia is the primary concern, beta-blockers work to reduce excessive heart rate. They are not a blanket treatment for all POTS patients and are typically not used solely to treat dehydration-related symptoms.
  • Ivabradine: Reduces heart rate without lowering blood pressure and may be helpful in managing tachycardia in some POTS patients.³

These medications aren’t one-size-fits-all. They must be prescribed based on your individual symptoms, medical history, and subtype of POTS. Close communication with your healthcare provider is key to finding the right balance and ensuring treatment is safe and effective. Learn more in our guide to Mastering Medications for POTS.

A woman checks her smartwatch to monitor her POTS blood pressure fluctuations.

Rapid heart rate can be a common symptom of blood pressure fluctuations in POTS. Monitoring your heart rate with tools like a smartwatch can help you stay aware and take proactive steps.

Tracking Blood Pressure Patterns

Keeping track of your blood pressure patterns is an important part of POTS blood pressure management, providing valuable insights into your body’s unique responses.

While fluctuations often feel unpredictable, consistent monitoring can help you recognize patterns, identify triggers, and adjust your management strategies for better control.

Tools for Tracking Blood Pressure

Choosing the right tools for monitoring blood pressure can make tracking easy. Here are some options to consider:

  • Wearable Monitors: Smartwatches and fitness trackers equipped with blood pressure functionality are convenient options for day-to-day monitoring. These devices can provide real-time data and help you observe fluctuations during specific activities.
  • Digital Blood Pressure Cuffs: A reliable home blood pressure cuff delivers precise readings and often includes features like memory storage or smartphone apps to log your measurements over time.
  • Manual Logs or Apps: If your device doesn’t automatically store data, maintain a journal or use a tracking app to log your readings. Include details like the time, your posture, and any noticeable symptoms for a more comprehensive view.² ³

Using these tools consistently helps you gain a clearer understanding of your blood pressure patterns, enabling you to take proactive steps toward managing your POTS symptoms more effectively.

Why Regular Monitoring Matters

Tracking your blood pressure isn’t just about collecting numbers—it’s about uncovering actionable insights. Monitoring allows you to:

  • Recognize Triggers: By tracking your blood pressure during different activities or conditions, you can identify patterns like symptoms worsening after dehydration or standing for extended periods.
  • Adjusting Management Strategies: Monitoring helps you evaluate the effectiveness of lifestyle changes or medications, giving you a better idea of what works for you.
  • Informed Healthcare Decisions: Sharing detailed tracking information with your doctor allows for more tailored treatment plans, ensuring your management strategies align with your unique needs.¹

Consistent tracking can feel daunting at first, but it’s one of the most effective ways to understand and manage your condition.

How to Make Tracking a Habit

Set reminders to check your blood pressure at the same times each day, such as morning, midday, and evening. Include notes about what you were doing or how you were feeling when the reading was taken.

Over time, you can use this information to better understand and manage your POTS symptoms.

Finding Balance with POTS Blood Pressure Fluctuations

Managing blood pressure fluctuations in POTS can feel overwhelming, but with the right combination of lifestyle adjustments, medical support, and consistent monitoring, you can regain control and improve your daily life. Small, steady steps can lead to significant improvements in your symptoms and overall well-being.

Get More Tips to Thrive with POTS

Stay proactive, work closely with your healthcare provider, and remember that progress is a journey, not a race. For more tips and strategies, explore our other POTS resources to help you live a balanced and fulfilling life with this condition.

Buoy Rescue Salt, featuring unrefined, hand-harvested sea salt perfect for managing blood pressure fluctuations in POTS.

References:

  1. Agarwal, A. K., Garg, R., Ritch, A. & Sarkar, P. (2007). Postural Orthostatic Tachycardia Syndrome. Postgraduate Medical Journal, 83(981), 478–480. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC2600095/
  2. Cleveland Clinic. (2023). Low Blood Pressure. Retrieved from https://my.clevelandclinic.org/health/diseases/21156-low-blood-pressure-hypotension
  3. Cleveland Clinic. (2023). High Blood Pressure (Hypertension). Retrieved from https://my.clevelandclinic.org/health/diseases/4314-hypertension-high-blood-pressure
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