May Survey: Blood pressure and ME/CFS

The May website survey is asking about blood pressure measurement and ME/CFS.

Blood pressure is the pressure of blood in your arteries – the vessels that carry blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to keep the blood moving round all parts of your body. Your blood pressure naturally goes up and down throughout the day and night, and it’s normal for it to go up while you’re moving about.

Two pressures are recorded – in mm of mercury – every time the heart beats. The higher reading (systolic) being the maximum pressure and the lower (diastolic) pressure being the pressure at rest.

The normal upper limit of blood pressure is around 120/80 and a lower pressure is normally OK down to about 100/70 (for the purpose of this survey) – below which it may start to cause symptoms. The commonly used medical definition of low blood pressure is 90/60 or below.

Some people with ME/CFS have a significantly low blood pressure – known as hypotension – which is diagnosed when the pressure is regularly at or below around 90/60. But symptoms can occur when it drops below 100/70. Having a low blood pressure is probably due to the fact that ME/CFS involves the autonomic nervous system – a part of the nervous system that helps to control your pulse and blood pressure.

Unlike high blood pressure (hypertension), low blood pressure doesn't normally increase the risk of having the sort of serious problems that can occur with hypertension such as strokes and heart attacks. But it can cause symptoms such as feeling faint, lightnededness and nausea – especially if the pressure falls quite significantly when you move from sitting/lying to standing. This is known as postural hypotension.

Low blood pressure is sometimes caused by medical conditions like diabetes and Addison’s disease which have symptoms that overlap with ME/CFS. So they need to be considered if someone with ME/CFS has low blood pressure.

If low blood pressure is causing symptoms, simple self-help measures – such as using compression stockings and cautiously increasing fluid and salt intake – may help. If it is causing more severe symptoms then drug treatment may be required.

When blood pressure is consistently raised (ie above 140/90), even when resting, this is called hypertension and it increases the risk of heart attacks and strokes.
It is estimated that around 5 million adults in the UK have undiagnosed high blood pressure – often without any symptoms. And the only way to know whether you have high blood pressure is to have it measured.

If you have slightly raised blood pressure (ie over 120/80 and up to 140/90) this can sometimes be successfully reduced by some simple lifestyle changes – such as reducing weight and salt intake. If blood pressure is constantly above 140/90 and lifestyle changes are not reducing it then drug treatment is likely to be required.
There is no research evidence to indicate that high blood pressure can be caused by ME/CFS or is more common in ME/CFS.

So it’s a good idea to know what your blood pressure is – especially if you are over 40, or there is any family history of high blood pressure. Your blood pressure should have been checked when your ME/CFS was first diagnosed.

  • If blood pressure is low then this could be playing a role in causing symptoms such as feeling faint or having difficulty with standing (orthostatic intolerance).
  • If blood pressure is normal that’s fine but it should still be checked every five years or so if you are over 40, or there is a family history of hypertension.
  • If blood pressure is raised then treatment obviously needs to be discussed with your doctor.

If you haven’t had a recent blood pressure check you could ask for this to be done at the GP surgery, or possibly at a local pharmacy.

The other option is to buy an electronic home blood pressure monitor – these are reliable, easy to use and not too expensive. This is well worth considering, especially if you need to monitor your blood pressure because it’s either low or high. One make that has good recommendations is the Omron.

Useful information from the NHS on high blood pressure

Useful information from the Mayo Clinic on low blood pressure

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