Could my dizziness be related to my blood pressure?

Posted , 7 users are following.

Hi,

For the last 6+ months, I have been struggling with dizziness when standing, lack of energy etc. A few seconds after I stand I feel light headed and usually have to stop for a few seconds until it passes. It lasts around 30-60 seconds usually then I'm fine until I sit down and stand up again. It's not every time, around half the time I would say. Occasionally I also feel like I'm a bit out of breath after it happens.

I have suffered from anaemia in the past and thought it might be this again so a few days ago I had a blood test (awaiting the results). But I have also been told on a few occasions to have my blood pressure checked because it was high.

I recently bought a home blood pressure monitor so I could track my blood pressure and let my doctor know the results if needed. I suffer from anxiety which means I don't think my readings at the doctors at very accurate because I'm anxious. I also occasionally take propranolol for anxiety which would reduce my reading. I had it taken on Tuesday and she said it was fine (I had taken propranolol before the appt).

The last time I took propranolol was on Tuesday (today is Thursday) so I assume it will have left my system so I can only assume my blood pressure readings from today are accurate (correct me if I'm wrong).

Lying down reading

112/69

Pulse 42

Standing reading

98/79

Pulse 78

Lying down reading

115/70

Pulse 46

At a recent doctor appt (duty dr) to discuss my symptoms the doctor mentioned postural hypotension and said to see my gp about my blood pressure it was 145/93 (no propranolol was taken) she advised me to stand up slowly (I often sit with both my legs up on the sofa).

I wondered do these readings suggest postural hypotension? or perhaps something else? I can't understand why my blood pressure is so high (probably anxiety related) then quite low, especially upon standing. I'm also a little shocked at my pulse because I'm not fit in the slightest.

If the blood results don't show anything I will be following up at the doctors regarding my blood pressure. I just think due to my anxiety it's going to be difficult to get calm readings as I do at home.

Any advice or suggestions of things to mention to the dr would be much appreciated.

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  • Posted

    Before you even mentioned it, I was thinking, sounds like classic hypotension - a form of low blood pressure.

    What I would advise, with the help of a friend, is to take your BP sitting down and then immediately after standing up. Most people will have a slight drop in BP, as the body struggles to catch up with the demand that has just been put upon it. It is important that you take your BP quickly after you stand, which is where a friend will come in handy. It the diastolic (lower figure) drops by quite a bit, then this will probably confirm it.

    What basically happens is that your tickover BP, rather like a car ticking over, is too low and when you get up quickly, your body takes all the blood and oxygen and your brain stalss, hence dizzyness and perhaps blackout. Which is why your GP says to get up slowly to allow your body to recover.

    Your BP isn't actually, it is on the low side, but it is your diastolic figure that will be causing the dizzyness and this is what the GP would be concentrating on. I would be interested to see your diastolic figure from taking your BP immediately after standing up. Your pulse also needs to be investigated, it is far to look and maybe a symptom of something else. Even when I was about 20, running several miles a day, swimming every day and generally walking everywhere, my pulse never got below 52.

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    • Posted

      Hi,

      Thank you for the reply.

      I think it's tricky for me to get an accurate reading at the doctor's due to anxiety as it's always higher when I'm there as is my pulse, so it doesn't reflect how low it gets at home which makes things difficult. I feel like the doctor will brush me off because if anything the reading at his office is high but the dizziness and lack of energy etc are horrible. 

      The readings below were taken this morning. The first one I was lying down, the second one was straight after standing and the third was lying down again after the standing reading straight after.

      1) Lying down reading

      112/69

      Pulse 42

      2) Standing reading

      98/79

      Pulse 78

      3) Lying down reading

      115/70

      Pulse 46

      I'm also wondering if I should stop taking the propranolol because if my blood pressure is low anyway I don't want it to go much lower. I only take this as and when and not on a regular basis.

      I have just retaken my blood pressure when lying down, standing then lying down again and it's as follows:

      1) Lying down

      118/78

      Pulse 51

      2) Standing

      105/84

      Pulse 77

      3) Lying down

      123/74

      Pulse 51

      These were all done straight after each other. When standing it seems systolic drops and diastolic rises, whilst my pulse jumps up quite a bit. 

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    • Posted

      Am in agreement with both Lily and RHGB.  I would certainly recommend requesting a review of your medication urgently and perhaps swapping to an alternative for your anxiety - there are new meds being prescribed all the time and many do not have any negative affects on BP/pulse.  The vertigo you are experiencing would definitely seem to be related to the expected drop in BP as you stand up - as the others have said, this change from sitting to standing is very normal but combined with your low pulse rate will obviously have an effect.  I myself have had low BP throughout my younger life and now in my early 60's it has increased, as it does with many people.  I am now achieving 'normal' readings whereas many of my friends of the same age who have had normal BP earlier in life are now on BP meds as their BP has risen also but taken them above normal range.  I am reaping the benefits I guess of having low BP in my younger days. 

      I definitely appreciate what you say about your BP being higher when taken at the doctors - its very common for this to happen and is called 'white coat syndrome', it happens to me to even though I'm not particularly anxious about have my BP taken at the doctors due to it being normally in the average range.

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    • Posted

      Hi Loxie,

      Thanks for the reply.

      I have heard of white coat syndrome and definitely think that and social anxiety plays a part in my blood pressure is high at the doctor's. I will take the readings I have taken with me as I'm sure they will be completely different when I'm at the doctors and feeling nervous.

      I will definitely speak to my doctor regarding the propranolol. Although having not taken that for 2 days now I'm not sure that's why the readings I have given are low as I believe it's quite a short acting drug?

      That's good you're now reading in the normal range and as you said seeing the benefits now! I wouldn't mind if it wasn't for the dizziness and lack of energy.

       

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  • Posted

    Hi Lubilou,

    I would agree with what RHGB says - that this does sound like POTS (postural orthostatic hypotension). The systolic of 98 in some of your standing readings is a bit too low. Provided you're careful about not standing up too quickly, this could work on your side. Maybe I'm wrong, but I get a feeling from your post that you're still quite young. It's never a bad thing if your BP is slightly too low in your youth. BP tends to rise as you go through life anyway, so it's actually quite good if you have a low starting point.

    It does sound to me as if maybe the propranolol isn't such a good idea in your case, especially as it's clearly bringing your pulse rate down too far. Unless you're an athlete in regular training a pulse rate of under 50, even at rest, is on the low side. This is a typical side-effect of beta-blockers like propranolol.

    As a former nurse, I have to say I'm a bit surprised your doctor told you it was OK for you to stop and start propranolol at will. Normally this is a medication that you have to stay on, and only stop taking it under medical supervision with a slow taper. But it may well be that my knowledge on this is out of date.

    I hope the blood test you had is going to include thyroid function, as an underactive thyroid can cause low BP and especially a low pulse rate.

    It does seem to me as if you might be a bit over-anxious about your health. In general, "talking therapies" like CBT are much better than medication for treating anxiety, though you do need to find a good therapist who you can get on with.

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    • Posted

      Hi Lily,

      Thanks for the reply.

      I'm going to do a bit of research on POTS and mention it to the doctors when I go to see what they think. 

      The readings above, I don't think will have been affected by the propranolol as that was taken on Tuesday morning (1x 40mg) and from my understanding, it's only short acting. I will be speaking to the doctor about it though as if it's low when I'm not taking it then it might reduce it further. I'm 30 and work from home so I don't do much walking or exercise at all.

      It does say on the packaging take one a day but on the instructions says for anxiety take one before an anxious situation and I asked the doctor about taking it as and when. This was a while ago now though and I have yet to have a review of using it.

      Yes, it's going to include a test for anaemia, thyroid, vitamin deficiency etc.

      I wouldn't say I have health anxiety but I can be a bit of a worrier. My anxiety is around social situations but I do plan on asking the gp about talking therapies next time I go.  

       

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    • Posted

      You know, it might be a good idea to get some regular gentle exercise. This is normally recommended for high BP but it can be just as useful for low BP, by getting your cardiovascular system accustomed to sudden changes in demand - which seems to be a problem in your case.

      I work from home too, but I incorporate regular walking into my routine. For example, I have to go in to the office 2-3 times per month. This is about a mile-and-a-half from the nearest tram stop, so I walk the last bit. Coming home afterwards, I usually skip the tram and walk the three miles to the metro. I walk to the supermarket, two-and-a-half miles away, twice a week, coming home on the metro if I'm heavily loaded. I also do a half-hour programme of mixed aerobics, strength and flexibility 4-5 afternoons a week at home. It's quite easy to fit gentle exercise in around your normal routine, and it's actually better (and cheaper!) than a vigorous weekly workout at the gym.

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    • Posted

      Hello,

      I just glanced at this and something caught my eye... I don't have time tonight to read all the discussions, but I do know lily has great advice in this subject, and she is very knowledgeable....just want to let you know that I was diagnosed with social anxiety about twelve years ago ..... I tried all meds, because when I was in a social situations I pretty much tried to ignore symptoms and keep going... but my problem was I got bright red just before, let's say even a college class, and people would say omg your so red, which made it worse, and then I would break out in hives on my face... at that time Donnie Osmond was going thru the same thing ( go figure 😊winkHe got on Paxil for social anxiety and it helped....told Doc about it and I started......Paxil saved my life.... I was able to talk in front of people and even started dating... I still continue on Paxil to this day ...maybe read about it!!!!!Coral 😊🏝🇺🇸 Forgot to tell you, it also helped me from getting dizzy and passing out... 

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    • Posted

      Hi Coral,

      I'm glad Paxil (paroxetine) helped you. I would, however, sound a note of caution for anyone else thinking of asking their doctor to prescribe it.

      It's a powerful antidepressant that has only started being prescribed for anxiety in recent years. It can be very effective, but can cause severe side-effects in some individuals. It depends on your own metabolic make-up, but Paxil can actually increase anxiety and dizziness in some people!

      It's also quite hard to withdraw from - though I have to say nowhere near as difficult as the highly addictive benzo group, which was the previous go-to for anxiety.

      In my experience, mild anxiety is generally best dealt with by CBT or other "talking therapies", though if severe enough to be disabling it may well require medication as well. In any case, I'd advise anyone deciding to take a prescribed antidepressant for anxiety to start on the lowest possible dose.

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  • Posted

    Your questions are very good.  Print your post off and give it to your doctor or doctor's nurse to gain better insight and understanding!  GOOD LUCK!!

     

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  • Posted

    I would suggest  the term  "white coat hypertension" which is when you have higher blood pressure readings in your doctor’s office than in your home. This could explain the blood pressure spikes every time you visit your GP.

    And something else: Is there any issue with leg varicose veins? Enlarged  veins could lead to blood pooling in your legs resulting in postural hypotension.

     

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  • Posted

    Propranolol is a beta-blocker which DOES cross the blood brain barrier..  This means in plain English that it will slow down your heart rate, make you tired, perhaps depressed and give you nightmares as well.  Beat-blockers that cross the blood brain barrier makes a person dizzy as opposed to some other beta blockers such as atenolol.  Propranolol tagets the nervous system.. no wonder you feel dizzy upon standing..  You doctors, like most, are looking in the wrong places for something which they prescribed.. talk to your pharmacist  he/she will confirm what I have said.  Good Luck
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    • Posted

      You are very welcome RHGB,  I also suffer with a blocker that crosses the blood brain barrier.. Here in the US in recent years they try not to give blockers as 1st line of defense for hypertension.  I look forward to the day when side effects from drugs will be eliminated but that's too much to ask.. The concern for doctors here is to treat the illness not the patient...

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    • Posted

      Ann, I'm afraid the phenomenon of doctors treating the illness rather than the patient is far from being confined to the US! It's hardwired into most of the medical professions.

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    • Posted

      I see you are a member of the amlodipine group, do you take that as well. I did, I had to give it up a couple of months ago, because the side effects were just too bad.
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    • Posted

      Lily.. I totally agree.. since I've only experienced interaction with doctors here in the States, that is what I based my judgement on.. I have, however, read enough posts from your side of the pond to realize the same holds true elsewhere.. What is wrong with these people I wonder?

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    • Posted

      I did for a brief period RHGB and after reading horror stories about this drug I stopped.. I didn't know when it was prescribed for me that it was Norvasc which I've had problems with previously.. I try to read everything about what goes into my system..

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    • Posted

      Hi Ann,

      To be fair, I think it's often a case of six of one and half-a-dozen of the other. Many patients are too ready to allow themselves to be bullied by their doctors.

      I can understand this to some extent in countries like the UK and, I believe, Sweden, where patients have little or no choice as to their medical advisors. In the UK patients are sometimes threatened with being bumped off their general practitioner's list for non-compliance.

      However, this clearly isn't the whole story, as many people here in Belgium also appear to be in thrall to their doctors. There has to be an alternative explanation here, as we have one of the best medical systems in the world - somewhere between the UK and US in cost. Under our compulsory State medical insurance system, I can elect to see a doctor or dentist literally anywhere in the country, and can move freely from one to another - though I have to pay slightly more if consulting a GP other than the one I elected to nominate as mine. (Admittedly, the whole-country thing is not such a big deal as it sounds, as Belgium is smaller than the state of Maine!wink)

      And still I know people who are suffering what appear to be severe side-effects from medication, or even possibly unnecessary surgery, without daring to question their doctors about it. So what is it then?

      My own theory is that this attitude grew out of the advances in medical science in the 20th century. Until then, the chances you'd die of something nasty well before you reached your biblical three-score years and ten were pretty high, wherever you found yourself on the social scale. People were far more pragmatic about accepting their own mortality.

      Now we all want to live forever, and medical science seems to encourage this aspiration. Paradoxically, this seems to make people far more worried about their health. They start fearing that even the most minor deviation from "normal" threatens their longevity and requires treatment. Unfortunately, too many of their doctors - possibly under influences I can't mention here - are only too keen to comply and prescribe treatment. How many cases do we read of on these boards where otherwise healthy middle-aged people have been put on powerful medication for a BP that is barely border-line high?

      Unfortunately, this has a knock-on effect on those of us don't want "a pill for every ill". Because the majority of people are clamouring for a prescription or a procedure, the average doctor assumes that applies to all of us. Those of us who have just consulted a doctor for reassurance or explanation of our symptoms, and possibly life-style advice we can implement ourselves, also tend to come out with a prescription or a referral for some kind of intrusive examination. This is why I'd always encourage people to research their own condition, in tandem with consulting their doctor.

      I'm certainly not tarring all doctors with the same brush. When I was growing up in the UK - when the dinosaurs walked the earth - we had a wonderful family doctor of the old school. I've also been lucky for the most part with my medical advisors during my 40+ years in Belgium - with the added bonus I could fire them and get another one if I wasn't happy! I have to say that my current GP, who I stumbled across purely by chance after a house move four years ago, is absolute perfection. He's always ready to listen and consider alternatives to medication, while knowing when to issue warnings that it's really needed - which makes me far more likely to comply, of course.

      I think the advice to patients always has to be: "caveat emptor" (buyer beware). It's your body, and you should have the last say as to what happens to it.

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    • Posted

      Bravo Lily,  I couldn't agree with your more..  The medical profession has changed even in my lifetime and I prefer old school doctors to the newer breed.. However, they are dying out or retired.. I don't like scare tactics and that is what I find annoying not only in this profession but generally speaking in other areas of life.. and why not people are raised differently in today's world..

      I did come across several books written by a physician who is deceased but his slant on hypertension is unconventional to the known world of what passes for expertise in this filed.  I recommend his books to everyone, so if you are interested may I suggest you give him a read... for all concerned who might be reading this post  the author is Dr. Samuel J. Mann, and the books are Healing Hypertension and Hypertension and You.   He makes a good argument that most of us are on the wrong BP medications and I believe him..

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    • Posted

      Thank you Ann. I've bookmarked one of his pages as I suspect your post might disappear before too long! (They sometimes get a bit funny about book promotion or mention of doctors' names on these boards.) I'll read up on him at leisure.

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