Low blood pressure and dizziness upon standing

@bennettad
I have had a ICD/Pacemaker since 2006 (3rd device). I am on Entresto and Carvididol.

When my weight is under control my BP is 90/60. It causes some minor dizziness if stand up to quick. My heart failure doctor (Mayo Clinic) advised me to stand slowly, which I do now. He said if BP got lower and I had symptoms increased he would separate my medications and not take them at same time. The main thing of dizziness they asked was it temporary or did it continue for any significant length of time (more than a few seconds).

Some BP medications do cause fatigue. When I first started Entresto and Carvididol I had fatique and soreness. It was pretty significant and complained to my doctors. My EP and HF doctors said was normal and would take weeks maybe months for my body to gradually get used to the medications.

They were right and gradual I got better as would not have been able to function if it had not improved. Many people I know start Entresto and complain about fatique. I tell them my experience and to give it a chance. Some came back and said it did gradual get better and some said it did not. Those (did not) wanted a different medications and their doctors changed them.

Hello @bennettad, that must be a difficult line to walk between being low in the morning and higher at night. Battling fatigue during the day when you want to be most active has to be a frustrating daily occurrence.

You mentioned your cardiologist is not concerned, but that does not necessarily address your issue of lack of energy. Did you discuss the reduction of your medication with them? Despite their lack of concern, it is wise to keep your cardiologist in the loop with any change in medication as completely reducing or eliminating can also have adverse effects. Although members can share their experiences, offering medical or medication advice is against the community guidelines and should always be cautioned by having an open honest discussion with our providers with any medication or treatment changes.

@bennettad - when you mentioned your cardiologist wasn't too concerned, was that about the blood pressure levels or your fatigue? Did they offer any guidance on how to combat that feeling?

I'm so very sorry about your problem with the low blood pressure. My husband is dealing with that also. He has gone through many tests and the next one is the Lexi Scan test. His blood pressure at rising in the morning is usually 53/37. He often faints, has severe dizziness, and it lasts mostly through the entire day. He was originally diagnosed with Orthostatic Hypotension but they have since learned that he has LBBB (Left Bundle Branch Blockage) and also a calcium score of 4090. We see his Cardiologist again the day after his Lexi Scan for their results and opinion on what is to be done to help him. For now he is started on Midodrine to raise the blood pressure. He takes it 3 x a day and is on the max dosage of it. So far, there is usually the evening reading that is often 92/59 so it helps a little for him, but not totally. So, it definitely sounds like you have Orthostatic Hypotension to begin with. Only your doctor ordering tests and your insistence that they keep testing until something is found will truly help you. I'm wishing you the best and hope that you keep us updated. Your health is important and I'm glad that you are searching for the answer. Have a blessed day.

Thank you for this response. And I thought MY BP was low!! 52/37 is astonishing. My calcium score was also over 4000. I’ll check with my cardiologist about LBBB and Orthostatic Hypotension. I’d love to hear the results of the Lexi Scan.

All the best to you and your husband.

Bill

I have both high and low depending on my position. I can go from 150/60 to 80/42 in a matter of two three minutes
This has made me extremely stressed and afraid to leave the house
I'm looking for a support group I have not been able to find a Doctor Who can help me with my medication dose

Sorry you have this problem. My blood pressure numbers are a lot like yours, but not based on position, and systolic is often higher than 150. I don’t have much to suggest that could help you. But I wonder if you have done autonomic nervous system testing?

Hi @mariepresti . Thank you for commenting! Swift changes in blood pressure has to be super scary.

You mention medication dosing may be a factor. One idea as you wait for input from others might be to go to your pharmacist and ask them for guidance. What medication(s) do you take, and does more than one doctor prescribe them?

Your medication profile is most important. I’m hoping you have a primary physician to work with. The first step is for you to ask them to eliminate any medication or OTC that
might be causing low BP. If that is not the cause heart function and rate testing with monitoring is next. Diabetes
is implicated in one type of hypotension. This situation can occur in some patients with hypertension under treatment with several drugs.
The autonomic nervous system controls blood pressure. It is sometimes due to a neurological disorder.
You are at risk of fall or cardiovascular event so be sure to
consult your doctor or clinic promptly. Consulting your pharmacist about side effects and drug interactions is also
helpful when you are on multiple meds.
There are drugs to treat orthostatic hypotension if that is a problem after diagnosis is confirmed.