POTSPOTS Heart Rate: How to Graph It with Apple Watch
What heart rate numbers matter in POTS, how often Apple Watch measures them during a test, and how to graph and compare tests over time.
Which heart rate numbers matter
Three numbers anchor a stand test: resting heart rate lying down, standing heart rate at set minutes, and the rise, the highest standing reading minus the resting one.
Minute 5: 104 minus 72 = 32 bpm (the largest, so this is the rise)
Tap a bar to do the subtraction.
In adults, a sustained rise of at least 30 bpm within 10 minutes of standing meets the heart rate part of the POTS definition, and 40 for ages 12 to 19 (Freeman 2011, CCS 2020). Guidelines describe a standing heart rate above 120 as supportive (HRS 2015). Your doctor reads these with blood pressure and symptoms.
Can Apple Watch measure this?
A sample every few seconds: enough dots to see the rise take shape. (240 readings)
During a workout session, Apple Watch samples heart rate every few seconds, enough to plot a 20-minute test. Everyday wear gives far sparser readings. The watch does not diagnose POTS, and Apple offers no POTS detector. A loose band, cold hands or movement can throw the optical sensor off, so wear it snug and stand still.
How the POTS app graphs it
The POTS app starts a timed test from the watch: 10 minutes lying, a vibration when it is time to stand, then 10 minutes standing. The watch hides your live heart rate, because watching the number can change it. The phone graphs the result with the stand marker, the six marks and any symptoms you logged. Typed pulse oximeter readings appear as separate points.
Why compare tests over time
- Test 1: Hot day
One test shows one day.
Sleep, hydration, heat, caffeine, medicines, your cycle and illness all shift the rise. Repeat the same protocol at a similar time of day, log what changed, add blood pressure when you can, and bring the trend to your appointment.
Safety
Stand next to a wall or chair and sit down at the first sign of fainting.
This page informs and does not diagnose. Only a clinician who can examine you and see your whole history can interpret your numbers.
- Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Autonomic Neuroscience. 2011;161(1-2):46-48.
- Raj SR, Guzman JC, Harvey P, et al. Canadian Cardiovascular Society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Canadian Journal of Cardiology. 2020;36(3):357-372.
- Sheldon RS, Grubb BP, Olshansky B, et al. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-e63.
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- How to Test for POTS at Home: The 10-Minute Stand Test
- POTS Symptoms: The Common Ones and What They Mean
- How POTS Is Diagnosed: Criteria, Stand Test and Tilt Table
- NASA Lean Test for POTS: How to Do It at Home
- Do I Have POTS? What to Check Before You See a Doctor
- Tests to Ask For When You Suspect POTS
- Why Does My Heart Race When I Stand Up?
- Orthostatic Intolerance: Types and How POTS Fits In
- Why Blood Pressure Matters in a POTS Stand Test
- What Is Dysautonomia, and How Does It Relate to POTS?
- What Causes POTS? Subtypes, Triggers and What the Evidence Shows
- POTS and Long COVID: What the Research Shows
- POTS in Teens, Young Adults and During Pregnancy
- POTS Treatment Overview: What Guidelines Recommend First
- Fluids and Salt for POTS: What the Trials Show
- Compression and Exercise for POTS: Two First-Line Treatments
- POTS Medications: What Each One Does and What the Trials Show
- Living With POTS: Triggers, Pacing, Heat, Meals and Sleep
Want a record to bring to your visit? The POTS app guides the stand test at home and graphs your heart rate. See the app