POTS heart rate chart: lying vs standing
A POTS heart rate chart puts your lying heart rate and your standing heart rate side by side, test after test, so the rise on standing is easy to see. The consensus definition used by most clinicians looks for a sustained rise of at least 30 beats per minute within 10 minutes of standing (40 in people aged 12 to 19), without a large drop in blood pressure. Only a clinician can say what your numbers mean.
What the standing test measures
The test compares two moments: after you have been lying still, and while you stand. Clinics use a tilt table or an active stand test; at home many people record the NASA lean test or a simple stand test their clinician describes. The number that matters is the rise: standing heart rate minus lying heart rate, and how long it lasts.
- Lying (resting) heart rate, after about 5 to 10 minutes lying flat.
- Standing heart rate at set points, often 1, 3, 5 and 10 minutes, and the peak.
- Blood pressure lying and at the same points, if you have a cuff, because a big fall in blood pressure points to orthostatic hypotension rather than POTS.
Do it only as your clinician advised, with someone nearby and a chair or bed behind you. Stop and sit or lie down if you feel faint.
A POTS heart rate chart you can copy
One row per test. The example rows show how readings are written; they are made-up numbers, not targets.
| Date, time | Lying HR | 1 min | 3 min | 5 min | 10 min | Peak | Rise | BP lying → standing | Notes |
|---|---|---|---|---|---|---|---|---|---|
| Example, 7:30 | 62 | 84 | 90 | 92 | 91 | 92 | +30 | 118/76 → 116/80 | Dizzy at 3 min |
| Example, 7:40 | 66 | 80 | 83 | 85 | 84 | 85 | +19 | 120/78 → 122/82 | After 500 ml water |
Reading the chart over weeks
A single test says little: heart rate on standing moves with sleep, heat, hydration, caffeine, time of day, your cycle and illness. Weeks of tests done the same way show the picture your clinician is looking for. Note anything unusual in the notes column rather than leaving the test out.
- Test at the same time of day, before caffeine, ideally in the morning.
- Keep the same method (lean or free stand, same timings).
- Write down what you noticed while standing: dizziness, greying vision, a pounding heart.
Using a POTS heart rate tracker instead of paper
Upright records the stand test as a POTS heart rate tracker: lying and standing peak heart rate, the rise, a flag at 30 bpm with a reminder to sit down if you feel faint, and an optional blood-pressure series at 0, 1, 3, 5 and 10 minutes. Trends show a 7-day standing heart-rate chart, and the report lists the average and largest rise for your doctor. With Upright Pro the test can read the heart rate a watch saved to Apple Health or Health Connect. It records; it does not diagnose. See also the POTS symptom tracker template and how to prepare for a POTS doctor appointment.
Sources
- Sheldon RS et al. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome. Heart Rhythm 2015;12(6):e41–e63.
- Freeman R et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011;21:69–72.
- Vernino S et al. Postural orthostatic tachycardia syndrome (POTS): state of the science and clinical care from a 2019 NIH expert consensus meeting. Auton Neurosci 2021;235:102828.
Track it in Upright
Upright is a POTS app that keeps this record for you: salt and fluids, symptoms and triggers, medications and the stand test, with a 30-day summary for your doctor. Free to log, on your phone or in your browser. Learn more about Upright.
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