What should you know about POTS and orthostatic hypertension?

POTS, or postural orthostatic tachycardia syndrome, describes symptoms that develop upright alongside an excessive increase in heart rate. Orthostatic hypertension describes a blood-pressure increase when a person moves from lying or sitting to standing. The two patterns can overlap, but one does not automatically explain the other.

A clinician may compare pulse and blood pressure after resting and during upright measurements. They may also review medicines, fluid intake, sleep, anaemia, kidney health and heart symptoms. Do not stop prescribed treatment because a home reading is high.

Keep a simple record of symptoms, posture, time of day, meals, heat exposure and any pulse or blood-pressure readings. Sit or lie down when lightheaded, rise in stages, and avoid driving or climbing while symptoms are active. Ask whether compression clothing, fluid or salt changes are suitable for you; these are not appropriate for everyone, particularly people with heart or kidney problems.

Arrange medical review for repeated upright readings, fainting, worsening exercise tolerance or symptoms that interfere with daily activities. Seek emergency help for chest pressure, severe breathlessness, new weakness on one side, trouble speaking, sudden confusion or loss of consciousness with ongoing injury. These symptoms can signal urgent heart or brain problems, including Angina, Stroke or Transient Ischaemic Attack.

Ask which measurement pattern you have, whether medicines could be contributing, and whether you need an electrocardiogram, blood tests or ambulatory blood-pressure monitoring. Discuss how existing Hypertension, Heart Failure, Chronic Kidney Disease, Obesity or Obstructive Sleep Apnoea may affect your plan.