Orthostatic hypertension in children and adolescents with postural tachycardia syndrome

We described a heterogenous group of children disabled by postural tachycardia syndrome (POTS) and evident orthostatic hypertension (OHT). Twenty patients met the diagnostic criteria for POTS + OHT. Their clinical characteristics were compared with those in 76 patients with POTS alone and 20 healthy age-matched controls. Multivariate logistic regression analysis was used to identify independent risk factors for POTS + OHT. Supine systolic blood pressure (SBP) was lower in the POTS + OHT group than in the POTS group (p < 0.05). Compared with the POTS group, the POTS + OHT group showed markedly increased upright SBP, upright heart rate (HR) and HR changes (p < 0.05). Headache was more common in the POTS + OHT group than in the POTS group (p < 0.05). Logistic regression analysis revealed that low supine SBP and headache were independent risk factors for OHT in POTS patients. Headache and low supine SBP were the main clinical characteristics of a novel syndrome of POTS associated with OHT.