Problem with circulatory regulation with pulsatile pressure in the head after sitting for a long time getting up and lying down
January 18, 2016 | 25,00 EUR | answered by Dr. med. Frauke Gehring
Hello. For 10 years, I have had a problem with regulating my circulation after changing positions. When I stand up after sitting for a while, I feel a pulse-synchronous pressure in my head which then subsides after 30 seconds. My BMI is 42, weight is 140 kg, I am a smoker, and I am 182 cm tall. Even when I lost 40 kg and started exercising, and even when I quit smoking for 4 years, the problem persisted. My blood pressure is 147/87 after sitting for a while. Even with taking blood pressure medication, unfortunately, nothing changes. I have been trying to find a solution for 10 years. My blood work is normal, neck x-rays are normal, ultrasound of carotid arteries, abdomen, and leg arteries are normal. A heart ultrasound showed no abnormalities, no murmurs, all done 4 months ago and nothing has changed. Please advise.
Good evening,
It seems that there is a dysregulation of your circulation here. When you stand up, the body seems to reflexively dilate the blood vessels in the head to ensure its blood flow (since blood tends to pool in the leg veins). This can happen independently of blood pressure, and can be more bothersome the heavier you are and the less trained you are. I would like to do a stress ECG to see how your blood pressure reacts to stress. Then, start an endurance training (cycling, walking, swimming, dancing) and regularly shower your legs with cold water after showering.
A Doppler examination of the leg veins can show if too much blood is pooling in the veins, which could favor this counter-reaction. In that case, support stockings would be helpful.
Of course, it would be nice if you could slowly start losing some weight again and quit smoking. This may not improve much here, but it will greatly reduce your risk of thrombosis.
Sincerely, Dr. Höllering
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