POTS Diagnosis and Blood Pressure Characteristics

Diagnostic Criteria

The American College of Cardiology defines POTS as a condition characterized by the absence of sustained orthostatic hypotension, with a heart rate increase of ≥30 bpm within 10 minutes of standing, or ≥40 bpm in ages 12-19, and normal blood pressure response to standing 1, 2, 3
POTS patients often exhibit excessive tachycardia, with standing heart rate exceeding 120 bpm 1, 3
The diagnosis of POTS requires explicit documentation that orthostatic hypotension is absent during the 10-minute active stand test or tilt-table testing, with no systolic BP drop ≥20 mmHg or diastolic BP drop ≥10 mmHg within 3 minutes of standing 1, 3

The American Heart Association recommends avoiding antihypertensive medications that could worsen POTS, such as beta-blockers in large doses, and using medications that lower blood pressure with extreme caution, as they may exacerbate orthostatic symptoms 4