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What Causes Fluctuating Blood Pressure

What Is Labile Hypertension

What Causes Fluctuating Blood Pressure? | Ask the Doctor

Q.I have high blood pressure and have been checking my blood pressure more often since my doctor added another drug. But lately, my readings have been all over the place. For example, one morning it was 127/70, but then it was 170/100 in the late afternoon. What’s going on?

A. You may have a condition known as labile hypertension, which refers to blood pressure that fluctuates far more than usual. Everyone’s blood pressure rises and falls many times during the course of a single day, sometimes even within minutes. Many factors contribute to these changes, including physical activity, emotion, body position, diet , and sleep deprivation. However, there is no clear definition or standard criteria to distinguish between normal and abnormal fluctuations.

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Potential Danger Of Fluctuating Blood Pressure

A recent cohort study of 1,000 Chinese men and women suggested that fluctuating blood pressure in the elderly between doctors visits can lead to decreased functioning of the brain. Findings were based on the China Health and Nutrition Survey, and followed 976 older adults who had three or more visits with blood pressure measurements from 1991 up to their first cognitive tests, and completed follow up cognitive tests at two or more visits in 1997, 2000, or 2004.

Researchers note that more studies and clinical trials need to be done, but early findings showed an association between higher long-term blood pressure fluctuations and faster rates of cognitive decline.

Controlling BP instability could possibly be a strategy in preserving cognitive function among older adults, researchers wrote in the study published in the journal Hypertension by the American Heart Association.

When The Problem Is Autonomic Dysfunction

In labile hypertension, blood pressure tends to spike upwards. Blood pressure that swings in both directions may be a sign of a different problem called autonomic dysfunction.

People with this problem have difficulty regulating involuntary functions such as heart rate, breathing and body temperature, in addition to blood pressure. We usually send these patients to cardiology for testing, says Dr. Lioudis.

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Ask The Doctor: What Accounts For Wide Swings In Blood Pressure

Q. My blood pressure has wide swings each day. It can go as high as 210/110 with even minor stress like grocery shopping, then fall to 100/50, which makes me tired and needing rest. I take 15 mg of isosorbide dinitrate and a slow-release nitrate for angina. I also take 10 mg of atenolol to slow my heart rate. My doctor says I’m just a “reactive person.” My diet is excellent, and I try to keep active. Could my adrenal glands have anything to do with this?

A. You certainly do have some big swings in blood pressure, which makes it risky to add more blood pressure medications to control those moments when your pressure is high. There are some conditions in which the adrenal glands pour out large amounts of adrenaline, which can cause surges in blood pressure. But that is unlikely to be precipitated by minor stress. More likely is the effect of the isosorbide dinitrate . When it kicks in, it could suddenly drop your blood pressure, causing the swings you see. Isosorbide dinitrate is also a slow-release nitrate, and it usually isn’t a good idea to take two of these at once. I suggest you ask your doctor to review your medications, including dosages and timing.

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Having A Blood Pressure Test

Fluctuating blood pressure: Causes, treatment, and prevention

A stethoscope, arm cuff, pump and dial was normally used to measure your blood pressure, but automatic devices with sensors and digital displays are commonly used nowadays.

It’s best to sit down with your back supported and legs uncrossed for at least 5 minutes before the test.

You’ll usually need to roll up your sleeves or remove any long-sleeved clothing so the cuff can be placed around your upper arm.

Try to relax and avoid talking while the test is carried out.

During the test:

  • you hold out one of your arms so it’s at the same level as your heart, and the cuff is placed around it your arm should be supported in this position with a cushion or the arm of a chair, for example
  • the cuff is pumped up to restrict the blood flow in your arm this squeezing may feel a bit uncomfortable, but only lasts a few seconds
  • the pressure in the cuff is slowly released and detectors sense vibrations in your arteries a doctor will use a stethoscope to detect these if your blood pressure is measured manually
  • the pressure in the cuff is recorded at 2 points as the blood flow starts to return to your arm these measurements are used to give your blood pressure reading

You can usually find out your result straight away, either from the healthcare professional carrying out the test or on the digital display.

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What Is The Treatment For Fluctuating Blood Pressure

For the treatment, you can try out various types of things. You can also get details about products like Blood Pressure Supplement, which prove quite useful. So you can easily get the best outcome when using it.

  • Normally observing your blood pressure. Abnormal highs and lows may anticipate future issues, so screen your numbers normally to get issues early.
  • Making a sound way of life changes. A solid way of life practices can assist you with staying away from blood pressure issues or vacillations.
  • Accepting prescriptions as recommended. Your primary care physician may recommend a prescription to help manage your blood pressure if the way of life changes isnt satisfactory.

Measuring Ambulatory Blood Pressure

High blood pressure can also be diagnosed through a special device called an ambulatory blood pressure monitor. A doctor, nurse or pharmacist will get you to wear the device for a full day. The device measures blood pressure every 20 to 30 minutes and gives the doctor an average of your blood pressures during the day and while you are sleeping. These devices are not available everywhere and can be uncomfortable to wear.

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What Is Normal Blood Pressure

Experts agree that a healthy adult should have a blood pressure of less than 120 mmHg for their systolic pressure and under 80 mmHg for diastolic pressure. While people’s blood pressure can change minute by minute, you need to chart the blood pressure over a period of time if you want to get an accurate evaluation of your blood and heart health.

High Blood Pressure And Daily Activity

Why Does Blood Pressure Fluctuate?

Check with your doctor before starting a new activity or increasing your level or intensity. Be active safely. Build up your levels of activity gradually.

Try to do at least 30 to 45 minutes of moderate-intensity physical activity on most, if not all, days of the week. This can be done in bouts of 10 minutes or longer, if that is more convenient.

Physical activity is any form of bodily movement performed by our large muscle groups. Moderate-intensity physical activity , such as brisk walking or cycling, is enough to provide health benefits.

Walking is a great activity for all ages. You may like to join one of the Heart Foundations community walking groups.

Some types of exercises, such as body presses and lifting heavy weights, can raise your blood pressure. Avoid these if you have high blood pressure.

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High And Low Blood Pressure Risk Factors

Both high blood pressure and low blood pressure need to be managed. Overall, its much more common to have high blood pressure. According to the American College of Cardiology, almost half of the adults in the United States now fit the new definition of high blood pressure. Not surprisingly, the risk factors for these two conditions are very different.

Things That Can Increase Your Risk Of Getting High Blood Pressure

You might be more at risk if you:

  • are overweight
  • eat too much salt and do not eat enough fruit and vegetables
  • do not do enough exercise
  • drink too much alcohol or coffee
  • smoke
  • do not get much sleep or have disturbed sleep
  • are over 65
  • have a relative with high blood pressure
  • are of black African or black Caribbean descent
  • live in a deprived area

Making healthy lifestyle changes can sometimes help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.

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What Is High Blood Pressure

High blood pressure means that there is higher than normal pressure inside the arteries either during systole , or during diastole .

  • If the pressure is high during the pumping phase , then the first number recorded with a blood pressure reading will be high.

  • If the pressure is high during the relaxation phase , then the second number recorded will be high.

High blood pressure is also called hypertension.

Fluctuating Blood Pressure: Seasonal Changes

Fluctuating blood pressure: Causes, complications and prevention

Just as temperatures change with the seasons, so does your blood pressure. Researchers have found that blood pressure and other cardiovascular disease risk factors show a seasonal pattern, with your cardiovascular risk peaking in winter.


To answer that question, see our post What Is Hypertension? See also New Hypertension Guidelines: Rethinking Blood Pressure Standards.

In fact, studies have found that the highest rates of cardiovascular eventssuch as heart attack and strokeoccur in the cold winter months. In one investigation, researchers found that blood pressure readings in the northern hemisphere were highest in December and lowest in June:

  • Systolic blood pressure, on average, was 2.9 mmHg higher in December versus June.
  • Diastolic blood pressure averaged 1.42 mmHg higher in December than in June.
  • In the southern hemisphere, systolic blood pressure was 3.4 mmHg higher in July compared with January.
  • Diastolic blood pressure was 0.8 mmHg higher in May versus November.

Cold weather can cause fluctuating blood pressure BP levels usually rise during the winter months.

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A Super Spike Within High Blood Pressure Readings

There are two different types of hypertension: steady readings and fluctuating blood pressure readings . Data shows that steady hypertension is far less dangerous than hypertension with blood pressure spikes. The latter is more concerning, because strokes and heart attacks occur at the moment of a spike.

Hypertension accompanied by a super spike is considered to be the most dangerous type of fluctuating blood pressure readings and should be feared. It is most frequent in people with long-standing hypertension and hardened arteries. Consider significant lifestyle changes to improve your situation. There are 5 lifestyle ingredients that can improve health no matter what. Otherwise you can address nutrition and start anti-inflammatory diet that can help your heart tremendously.

Be aware that cholesterol lowering pills do not reverse atherosclerosis. They do not remove cholesterol deposits from the arteries, neither they stop the process. They only lower, not regulate, blood pressure readings.

In fact, cholesterol lowering pills may cause more harm than good. They are shown not only to be less effective than diets, but also may contribute to deadly strokes. Know the little-known facts on cholesterol pills before trusting their benefits.

Target Your High Blood Pressure

Once you have been diagnosed with hypertension, remember that high blood pressure can be lowered. For most people, blood pressure readings should be lower than 140/90 mmHg when measured in the doctors office. At home, your blood pressure should generally be below 135/85 mmHg. For those people with diabetes or kidney disease, lower blood pressure is even more important and should be below 130/80 mmHg when measured in the doctors office.

Most people who lead healthy lifestyles do not suffer from high blood pressure. For those with hypertension, following the steps outlined above will lower their blood pressure.

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High Blood Pressure And Older Adults

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High blood pressure, or hypertension, is a major health problem that is common in older adults. Your bodys network of blood vessels, known as the vascular system, changes with age. Arteries get stiffer, causing blood pressure to go up. This can be true even for people who have heart-healthy habits and feel just fine. High blood pressure, sometimes called “the silent killer,” often does not cause signs of illness that you can see or feel. Though it affects nearly half of all adults, many may not even be aware they have it.

If high blood pressure isn’t controlled with lifestyle changes and medication, it can lead to serious health problems, including cardiovascular disease such as heart disease and stroke, vascular dementia, eye problems, and kidney disease. The good news is that blood pressure can be controlled in most people.

Hardening Of The Arteries

What is more dangerous, high or fluctuating blood pressure?

Arteries consist of collagen, elastin fibers and cells. When they are young, they have more flexibility and can bounce back between heart beats. As you age, they get stiffer for the following reasons:

  • Elastin fibers decay with age.
  • Calcification is caused by increases in calcium.
  • Changes in collagen disrupt the elasticity.
  • Lowering systolic in the elderly.

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Tips For Taking Blood Pressure Medication

Untreated high blood pressure can increase your risk of serious health problems. If your doctor prescribes medication to lower your blood pressure, remember:

  • If you take blood pressure medication and your blood pressure goes down, it means medication and lifestyle changes are working. If another doctor asks if you have high blood pressure, the answer is, “Yes, but it is being treated.”
  • Healthy lifestyle changes may help lower the dosage you need.
  • Get up slowly from a seated or lying position and stand for a bit before walking. This lets your blood pressure adjust before walking to prevent lightheadedness and falls.
  • Tell your doctor about all the drugs you take. Don’t forget to mention over-the-counter drugs, including vitamins and supplements. They may affect your blood pressure. They also can change how well your blood pressure medication works.
  • Blood pressure medication should be taken at the same time each day as part of your daily routine. For example, take it in the morning with breakfast or in the evening before brushing your teeth. If you miss a dose, do not double the dose the next day.
  • Remember to refill your medication before you run out and bring it with you when traveling. Its important to keep taking your medication unless your doctor tells you to stop.
  • Before having surgery, ask your doctor if you should take your blood pressure medication on the day of your operation.

Home Remedies And Lifestyle Changes

The following can help normalize blood pressure:

  • Stopping smoking: Smoking harms the arteries and can cause high blood pressure.
  • Eating more fruits, vegetables, whole grains, and lean protein: Reduce or eliminate added sugars and processed foods.
  • Getting regular exercise: The American Heart Association recommends moderate-intensity exertion, such as walking at a quick pace. A person should do this for 30 minutes per day, at least five days a week.
  • Limiting alcohol consumption: Women should drink no more than one drink per day and men no more than two drinks per day. Drinking more than this can raise blood pressure.
  • Finding healthy ways to lower stress: Meditation, deep breathing exercises, guided imagery, and other techniques to manage stress can help to avoid spikes in blood pressure.
  • Consuming less sodium: Excessively salty foods can cause sharp increases in blood pressure.
  • Reducing the intake of caffeine: Caffeinated drinks can cause temporary spikes in blood pressure, and may make anxiety worse.

Consult a doctor for personalized guidance.

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Common Causes For Fluctuating Blood Pressure

Food sensitivities: Consuming foods that dont agree with us can cause a spike in blood pressure. This is commonly seen in salt sensitivities or after consuming high amounts of salt. Although this issue will resolve on its own a few hours after consuming the trigger food, you may want to make diet changes in order to prevent future fluctuations.

Stress: During times of stress, our arteries constrict, causing the heart to work harder. This in turn raises blood pressure along with blood sugar and heart rate. If you live with chronic stress, this constant strain on the heart can lead to artery and heart damage, increasing your risk of a cardiovascular event.

Caffeine consumption: Caffeine is a stimulant, so our hearts tend to race when we consume something containing caffeine. As a result, a faster-pumping heart causes blood pressure to rise. This usually resolves within a few hours. Regular caffeine consumers may not notice the changes, but those who consume caffeine infrequently will.

Medications: Certain medications, such as decongestants and anti-inflammatories, may result in a temporary elevation of blood pressure. Illegal drugs tend to have the highest impact on blood pressure, which is what in part makes them life threatening.

Fever: Often a result of fighting infection, a fever can speed up heart rate, leading to a rise in blood pressure.

Dehydration: Insufficient hydration can result in blood pressure fluctuations with a large decrease.

Increased Blood Pressure Fluctuations Linked To Impaired Cognitive Function In Older Adults

Is It Normal for Blood Pressure to Fluctuate?

A study found that increased blood pressure fluctuations are linked to impaired cognitive function in older adults. Researchers investigated visit-to-visit blood pressure variability with cognitive function among seniors who were at a high risk for cardiovascular disease.

The study looked at 5,461 seniors over the age of 70 with an average follow-up time of three years.

Blood pressure was measured every three months in the same clinical setting, and the variability between the measurements was analyzed.

Selective attention and reaction time, general cognitive speed, immediate and delayed memory performance were also assessed.

The researchers found that blood pressure variability was associated with worse performance on all cognitive tests, and the results remained the same even after taking into consideration cardiovascular disease risk factors.

Higher visit-to-visit blood pressure variability was associated with lower cognitive function, as well as higher stroke risk.

Researcher Simon Mooijaart explained, We showed that high visit-to-visit systolic and diastolic blood pressure variability associates with worse performance in different domains of cognitive function, including selection attention, processing speed, immediate verbal memory, and delayed verbal memory.

Whether higher blood pressure variability is a cause or a result of cognitive impairment is still unclear.

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