Welcome @mcolton16
You may wish to take part in this discussion:
- Exercise-induced Hypertension https://connect.mayoclinic.org/discussion/exercise-induced-hypertension-systolic-230/

And the conversations in the post-COVID support group here:
- Post-COVID Recovery & COVID-19 https://connect.mayoclinic.org/group/post-covid-recovery-covid-19/

Did you develop POTS and hypertension only after having COVID?

@mcolton16, I took your question to Dr. Dudenkov, an internal medicine specialist at Mayo Clinic, who wrote the above blog post. He has this information for you.

"It is very common for patients with POTS (whether post-COVID or after any other trigger) to be hyperadrenergic. This means that they have high levels of circulating stress hormones, most commonly adrenaline, much higher than patients without POTS. Adrenaline is further increased when standing or exercising. Two of the most common effects of high adrenaline is elevated heart rate and elevated blood pressure. Thus, it is not uncommon for us to see exercise induced hypertension (in addition to tachycardia) in patients with POTS.

It is important to understand that this elevated blood pressure while exercising is not inherently harmful. The key is not to stop exercising. With appropriate reconditioning, the blood pressure should improve also. I do not recommend monitoring heart rate or blood pressure while exercising, because it can cause anxiety and you may be tempted to not exercise, further making the situation worse.

For patients who are very symptomatic from their tachycardia and elevated blood pressure, to the point that they cannot tolerate even minimal exercise, it is also worthwhile considering a medication such as propranolol, which essentially helps block the effects of adrenaline on the heart and blood vessels, thus reducing heart rate and blood pressure. There are a few other medications that could also be considered, and I recommend discussing this with the provider who is helping manage the POTS. The purpose of a medication would be to help you increase your exercise, with the ultimate goal of discontinuing the medication."

So the important takeaway message, is to go slow, but to keep exercising. What kind of exercise do you do, mcolten?