Sitting and standing bp difference


I am 65 years old female. I got my Medtronic CRT-P implant 2 months back. Since the past couple of days I feel a fainting sensation in my head on changing my postures. I consulted my doctor and he adviced for a medicine in case I feel like fainting and also to record my sitting and standing blood pressure levels. So, I did the same and got the following readings, Sitting BP (135/73 pulse - 75) and Standing BP (119/56 pulse - 82). Is the fall in blood pressure normal on standing? Does it happen with anyone else too? 


I appreciate your inputs in advance


Sounds like what you have is ...

by donr - 2018-09-12 02:01:29

...Orthostatic hypotension.  It is NOT normal for BP to drop that much upon standfing.  He should have measured your BP right there in his office!.  He could have given you the answer right on the spot.


Thank you.

by India.joshi - 2018-09-12 02:05:13

But he didn't . Could it mean an issue with my pacemaker? 

Orthostatic hypotension

by India.joshi - 2018-09-12 02:07:18

Does it happen to other heart patients as well? Or people with pm implant?

Orthostatic Intolerance

by Beattie - 2018-09-12 07:19:30

I have Orthostatic Intolerance but i had this long before i got my PM. 

Interestingly, my Neurologist said my Last Tilt table test results had showed some improvement to the previous one i had before i got my PM.

I am on medication and find if i stay well hydrated it helps.

A good Neurologist that specialises in Autonomic Nervous System disorders should be able to help you. 


BP when standing

by AgentX86 - 2018-09-12 08:30:09

That difference is probably larger than most but even the lower number shouldn't cause even a light-headed feeling. It's a normal BP. Unless there is a major crash at the transition to standing, I don't think this is your problem.

Many of us feel lightheaded if we stand too quickly and have learned to stand more slowly ("Doc, it hurts when I do this...."). If it's really something you can't live with,  keep bugging your doctors, otherwise make sure they know about it (and remind them) and move on. It's very common.


by Tracey_E - 2018-09-12 08:52:55

They can do a tilt test to see how bad it is. The pacer can only control how fast your heart beats, not blood pressure, so if something is going on it's not cardiac. Medication and diet can help. Talk to your gp, a referral to a neurologist might be a good idea. 

Orthostatic intolerance/hypotension

by Going Forward - 2018-09-12 17:25:28

I have had it for many years (confirmed with a tilt table test). Mine used to drop more than 30 points systolic but I have been happy to see that after pacemaker implantation 3 1/2 weeks ago, it has improved and doesn't drop as much. I can also stand up much longer without feeling that I am going to faint. On my original tilt table test I ended up with a reading of 88/80 after about 25 minutes standing. That felt, well, awful!

Sitting and standing blood pressure difference

by LondonAndy - 2018-09-13 06:33:20

It is normal for there to be some drop in blood pressure on standing. Yours does seem to be dropping quite a bit, and this is a suggestion only as I am not sure this would be sensible or appropriate but it might be worth discussing your pacemaker's "rate response" setting and see if it should be adjusted to be more sensitive?  This would cause the device to increase beats per minute more quickly when it detects movement, which might well help the dizziness feeling but might also mean your heart races when you don't want it to.

Answers to extra questions

by Gotrhythm - 2018-09-15 12:16:50

As you have seen from the above replies, your problem isn't uncommon.

It absolutely is not caused by your pacemaker. Many people who don't have pacemakers have it too. It can come on at anytime, and happen at any age--although it is more common in older people. It isn't a sign of heart trouble.

Feeling woozy is uncomfortable, but your bp is not dropping to a dangerous degree. As someone else said, learn to stand up slowly. Stand by first bringing your feet close to your chair or bed. Then rise keeping your back as straight as possible. Don't take a step until the dizzyness has passed.

Rising that way will prevent many dizzy spells, and it will also insure that if you do begin to lose consciousness, you can easily prevent a fall just by sitting down.

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