inappropriate sinus tachycardia and diastolic hypertension

I have had PVCs for a long time, but no more than 20-30 or so in a day. were you able to discover what caused your diastolic BP to rise?

I have been looking into POTS, possibly something like hyperadrenergic POTS which causes high rather than low BP with standing up. My heart rate get high when I stand up, but it doesn't go higher than 90 now that I am on bisoprolol.

What was your BP like before the diastolic reached 100s? Was your bp spike accompanied with any other symptoms?

Mine caused flushing all over my face, even my palms were very red and warm to the touch. I had a severe headache and had chest discomfort too, even though the systolic was only about 130ish. The doctor thought it may have resulted from anxiety. Anxiety has never caused high BP for me before, and I wasn't anxious before any of this happened. When I would get very anxious in the past, if something super anxiety inducing happened, I would get very cold hands, dizziness and such. Never headaches, hot flushed skin, chest heaviness and so on. I have the feeling this isn't essential hypertension or anxiety.

A few days before this happened, my Bp was 115/60. The day I had a MIBI scan to see if my shortness of breath had cardiac causes, my BP was 120/67 and during the test (which made me anxious because I had a very bad reaction to the Persantine - nausea, headache, chest pain, shortness of breath) the highest it reached was 150/80. My heart rate did reach 160. Even so that diastolic didn't hit 100s. The body is just so weird and confusing sometimes.

Thanks for replying and sharing your experience. It helps to know I am not alone.

p.s. my BP stayed elevated for a few weeks until I started taking the beta blocker.

I have been having "spikes" for a little over a year, and unfortunately I do not have a good explanation. I also had facial flushing and cold hands during the early more severe spikes. My blood pressure before the spikes is generally around 125/85 (untreated by bp medicine), but when it spikes it usually reaches up to 150/100. I used to also experience thirst when having the spikes. I have had spikes as high as ~170/~110.

The best "guesses" for me after evaluation are that I am experiencing some sort of vasospasm caused by a dysfunction in my circulatory system. The spikes began occuring about one year after beginning treatment with Losarten 50 mg, and I was taken off all bp medicine. I tried 5 different bp medications and my body reacted to all of them.

Anxiety does make the spikes worse, so I suggest Cognative Behavioral Therapy and meditation. By using CBT techniques I think the magnitude of the spike is a little lower, and certainly more tolerable.

Also, when I "spike", I have learned to relax as much as possible, hydrate, find some time by myself if possible, and the spikes invariably pass. I have yet to determine a trigger, as they seem to occur randomly.

Finally, I did find cutting gluten out of my diet seemed to help, as it can be inflammatory in some people. I am not gluten intolerant (tested), but I did adjust my diet to eliminate gluten and reduce sodium, which seems to have helped. As others have posted foods rich in magnesium and other micronutrients also seem to help reduce the overall frequency.

You have my sympathy, and I am sure you will get through this. I am happy to share more as well if any of this helps you, and I am certain what you discover will help me.

Hi there, thanks for sharing and for the reassurance. Could I ask what the losarten was initially prescribed for? Was it for your BP or another condition? I ask as 125/85 before BP meds doesn't sound bad at all. I am sorry the BP meds didn't sit well with you. Many of them cause side effects. I am doing okay on the bisoprolol so far. Keeping fingers crossed it stays that way.

Could I ask which tests/scans helped them consider a vasospasm in the circulatory system?

I have been low carb and mostly gluten free for 6 months now. I read on the keto forum that a lot of people had their BP go up on keto. The running theory is that it's from electrolyte imbalances. Keto is the one big change I made in the past couple of months, and I am heavily considering if it was a factor. My sodium and potassium were normal, but the magnesium wasn't tested. Magnesium regulates heart rate and BP, so if I am deficient in it, that may explain the diastolic hypertension. My systolic doesn't go over 135 in these spikes. Even on the bisoprolol, I am getting a diastolic of 85 in most of the readings. It's much better than the 100 and high 90s. But I think it's curious that the diastolic is still a bit elevated. I don't feel any anxiety with the current BP, but when it was hitting 100s and causing headaches, flushing etc., that was anxiety inducing. The BP did lower eventually when that happened, as with yourself. But doctors think anxiety was the cause, which I don't think is right. I lost weight, have great cholesterol, great BG and if anything was less stressed, and still the diastolic went up and caused a ton of symptoms.

I would suggest getting your TSH, free t3 and free t4 tested to see if your thyroid might be involved.

Pheochromocytomas are quite rare, but they can also cause BP spikes (often in the 200s though for systolic but that's not necessary) with flushing/paleness, severe headaches, chest pain, anxiety. That sounds like it could be anything, but sadly most pheos are diagnosed via autopsies so people can have them for years and live with hypertension and never find out. If you're otherwise healthy and have sustained d iastolic hypertension and/or high spikes that are symptomatic, it might be worth discussing with your doctor. Also see if your white and red blood cells are normal. If they're both elevated, it may be a good idea to see an endo.

Thanks for sharing the excellent information. To answer your questions I was put on Losarten as I was hypertensive, but only mildly so (>135/>90), Losarten brought my bp down to <120/<80, but I was not monitoring it. When I finally did (after a year) it was down to ~100/~60 much of the time (therefore I was weaned off of it).

I have had extensive testing, including an echo, renal ultrasound, stress test and my heart is fine. Also went through testing for abnormal catecholmines, but those were normal. The only abnormal tests have been for high red blood cell count. I have also had my thyroid tested multiple times.

After a year of sporadic testing though I have kind of given up. I don't take any medication, but I do take 100 mg of magnesium daily, and that has really cut down the PVCs.

I have wondered if there is a connection to auto-immune, as it seems as though there may be a link between high diastolic readings caused by inflammation. That is why I quit the gluten, as I think inflammation seems to make the spikes more severe.

Finally, it was suggested to me that I consider reducing exposure potential to toxins, as those can cause non-specific symptoms (including labile hypertension). You may consider this as well.

Hi thanks for sharing! I am going to try the arugula. I have also heard chia seeds lower blood pressure. My inappropriate sinus tachycardia predates the BP by at least a decade. I didn't know that arrythmias could cause higher BP, but that would make sense.

On the bisoprolol, my BP stays between 105/75 and 110/85. Most often I see the diastolic as 85. Way better than hitting 90s and 100s, but I'd like it to be 80 or lower ideally. I walked quite a bit today, had some shortness of breath, even though my chest felt very still...it was relaxing that my heart wasn't racing. Still had the shortness of breath unfortunately. I tested my BP five minutes after I got home, just to see how it was impacted by activity. It was 110/85, which is exactly what I get if I have been sitting for half an hour. I am going to take my monitor to the doctor's again and see how it matches.

I can only have a small amount of beets, as I am on keto for managing t2d with which I was diagnosed very recently. Luckily, my A1C at diagnosis was 6.5, so lowering my carbs was enough to drop it to 4.8. And I am maintaining very well.

I am not sure if you're familiar with keto, but I read on keto forums that many people seemed to develop high BP on the diet! Turns out it's from electrolyte imbalances. Because my cholesterol is perfect. Blood sugar is excellent. Fasting is always in the non diabetic range, great A1Cs. So it's not the cholesterol or BG. I did start supplementing magnesium, in case all the peeing on keto had caused a deficiency.

p.s. does this board not have a post edit function?

Hi there,

Thanks for sharing your experience. It sounds very stressful to deal with AT and High BP.

I have been reading a lot about beta blocker withdrawal, and I am going to be very careful not to let doctors take me off Bisoprolol too quickly. I am sorry withdrawing from those other meds was a nightmare.

This whole heart rate thing is ridiculously stressful. I honestly wish I could go back to the time when I had tachycardia but no other symptoms.