Hyperadrenergic POTS
A POTS subtype driven by excessive sympathetic activation, often with high standing noradrenaline, hypertension on standing, tremor and anxiety-like symptoms. Distinct from neuropathic and hypovolaemic subtypes.
Reviewed 2026-05-15
What sets it apart from other POTS subtypes
The most commonly recognised POTS subtypes in the literature are neuropathic, hypovolaemic and hyperadrenergic. Hyperadrenergic POTS is distinguished by excessive sympathetic activation: standing plasma noradrenaline ≥600 pg/mL is the often-cited cutoff, and patients tend to have hypertension on standing (rather than the flat or falling BP seen in other subtypes), tremor, prominent anxiety-like symptoms, and a more "wired" flavour to the flares.
Why the subtype matters
Treatment leans differently for hyperadrenergic POTS — beta-blockers or central sympatholytics are often considered, where a neuropathic-pattern patient might be steered toward midodrine and volume expansion. Your specialist makes the call, but tracking standing BP alongside standing HR — both of which the app records — gives them the data they need. See also dysautonomia for the broader picture.