what can cause high blood pressure (mainly systolic but sometimes distolic)? I went to the ER Friday because my lightheadedness was much worse than normal, I constantly felt like I was about to faint, and chest pain. There they took orthostatic vitals where my systolic went from 120 something laying to 142 standing (distolic stayed around 65). I got no help from the hospital (they literally said my propranolol was probably making my blood pressure low?). I also don't know what symptoms are coming from what because I also have POTS.