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Thursday, December 12, 2013
High Blood Pressure
Meds vs meds
I have diagnosed with dysautonomia and high bp. My BP will drop up to 30 points upon standing and walking. My doctor has given me midodrene to help stabilize bp. At this time my heart races when I stand up (120 or more) and my bp drops from 150/90 plus to 114/80, my real concern is the tachycardia. What should I do?
It is difficult to give specific without having all the data. However, few points can be made:
For patients with autonomic dysfunction and blood pressure drop upon standing, it is recommended to take in at least 2 L of fluid and about 10 grams of salt a day to avoid dehydration. Sometimes compressive stockings can be helpful.
When anemia is present, it should be treated with iron and erythropoietin. In addition to midodrine, some patients respond to treatment with fludrocortisone.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati