Fluctuating Blood Pressure: Causes and Treatments

If you have ever gotten into a major argument with someone or experienced a large unexpected bill that causes your heart to plummet, you may have felt your blood pressure surge.

Certain stressful circumstances will trigger a spike in our blood pressure, which is normal as we approach the ebb and flow of life. 

Throughout the day, you can expect your blood pressure to rise and fall naturally as you go about your daily tasks — exercising, eating, sleeping, and moving around.

This is normal. However, in some cases, your blood pressure may fluctuate significantly, suddenly, and on a regular basis.

This condition is known as labile hypertension and it may point to a more serious health concern that requires medical attention.

In this article, I’ll go over what labile hypertension is and its causes. I’ll also go over the treatments and when to see a doctor.

What is Labile Hypertension

Labile hypertension is a condition where your blood pressure fluctuates more than normal.

While your blood pressure will naturally rise and fall throughout the day as you exercise, change body positions, sleep, hydrate, and eat, if you are experiencing regular fluctuations in a short time period such as a few minutes, can be signs of labile hypertension. 

Blood pressure is the measured force of circulating blood against the walls of blood vessels pumped from your heart through the circulatory system.

Your blood pressure is determined by the amount of blood your heart pumps through your body’s arteries and the amount of resistance to this blood flow. 

When there is too much pressure on your arteries because your arteries are too narrow or stiff, your blood pressure reading will be high.

This is a condition known as hypertension, which is usually determined when your blood pressure exceeds 130/80mmHg.

Labile hypertension is when there is a large variance in your blood pressure over a short period of time, and this type of variance happens quite regularly. 

It can be difficult to diagnose labile hypertension, as there is no definitive minimum number that your blood pressure has to reach to determine if you have the condition.

Rather, it’s more about assessing what your normal blood pressure range is, and seeing how far out of that range your blood pressure extends, as well as how frequently this happens.

If you suspect you have labile hypertension, you may experience the following symptoms:

• Facial flushing
• Intermittent headaches and tension headaches
• Heart palpitations
• Shortness of breath
• Fatigue
• Sweating‌
• Feeling uneasy

Fluctuating Blood Pressure Causes

It can be difficult to determine what causes labile hypertension.

Typically, it can be attributed to external circumstances, usually in response to stressful situations such as:

• A motor vehicle accident
• A dispute with someone
• Financial stress
• Anxiety
• Intense physical activity, such as aerobics or running
• Excessive alcohol or caffeine consumption
• Cocaine and other recreational drugs 
• Meals high in salt (especially for people who are sensitive to salt intake)
• Medications like decongestants
• Certain herbal remedies
• Certain eye drops
• Pain

In some circumstances, an underlying medical condition may be causing labile hypertension.

Your doctor will treat that condition, which should then improve your blood pressure levels.

Medical conditions associated with labile hypertension include:

• Adrenal glands issues
• Cardiovascular disease
• Cerebrovascular disease, especially in the elderly
• Kidney disease ‌
• Posterior reversible encephalopathy syndrome (PRES)
• Sleep apnea

Medications and Treatments 

If you are not taking blood pressure medications as prescribed by your doctor, this can also lead to labile hypertension.

If you have high blood pressure, your doctor may treat it with the following medical treatments:

• Angiotensin-converting enzyme (ACE) inhibitors: Angiotensin is a chemical that causes the arteries to become narrow. ACE inhibitors help the body produce less angiotensin, which then allows the blood vessels to relax and blood pressure to lower.
• Angiotensin II receptor blockers (ARBs): This medication blocks angiotensin, working to reduce blood pressure by allowing the blood vessels to relax and blood to flow more freely.
• Calcium channel blockers: These work by relaxing the muscles of your blood vessels, reducing your heart rate, and lowering your blood pressure. 
• Thiazide diuretics: Your doctor may prescribe these ‘water pills’ which help your body expel excess sodium and water through urination. They are often taken with other medications.
• Beta blockers: This medication blocks the effects of epinephrine (otherwise known as adrenaline), which can lower your heart rate and blood pressure.

After taking any prescribed medication for some time, your blood pressure may lower.

It is important you continue to take your medication regularly and do not stop taking them without first discussing with your doctor to avoid hypertension or labile hypertension.

Risks Associated with Fluctuating Blood Pressure

Hypertension is a very common condition affecting almost half of all adults in the US.

Normal blood pressure is considered 120/80mmHg or less in adults and children over the age of 13 years old.

If your blood pressure fluctuates higher than this and stays there, you fall into the category of high blood pressure (hypertension).

Having high blood pressure or fluctuating blood pressure can put you at a greater risk of the following health conditions:

• Heart attack
• Heart failure
• Stroke
• Eye damage
• Kidney damage

Lifestyle Changes

In addition or as an alternative to medications, consider making the following lifestyle changes to help you lower your blood pressure and keep it consistent.

• Eat a healthy diet: Scientific studies have found that adopting the Dietary Approaches to Stop Hypertension (the DASH diet) can help you control your blood pressure. The diet consists of 100% whole grains, fruits and vegetables, legumes, and plant-based proteins. Swapping out fattier meats for leaner plant-based proteins and minimizing sugar, salt, sodium, and dairy intake can vastly improve your blood pressure levels.
• Exercise regularly: Being physically active for at least 30 minutes a day most days out of the week can greatly reduce hypertension. Consider walking, cycling, yoga, or even doing chores around the house to get your body moving.
• Limit alcohol intake: Alcohol can raise your blood pressure and cause it to fluctuate. Consider cutting back on your alcohol consumption to just one alcoholic beverage when you do drink.
• Reduce stress: Stress is how your brain and body react to pressure. If you are currently in a stressful situation or having a hard time managing your reactions to things, incorporate meditation or breathwork into your life to help you relieve stress. Try to keep a regular bedtime routine and get at least eight hours of sleep a night.

Maintaining Healthy Blood Pressure Levels

In addition to medications and lifestyle changes, you can help regulate your blood pressure with a range of herbal remedies.

Studies have found that there are certain vitamins and supplements that you can take that can improve labile hypertension. 

• Vitamin C: John Hopkins University has discovered that taking 500mg of vitamin C daily can lower your blood pressure. 
• Potassium: Potassium helps clear sodium from the body. If your diet is high in sodium, this will be particularly beneficial. Sodium stops the kidneys from removing water from the body efficiently. Increasing your potassium intake can help expel sodium in your urine and relax the walls of your blood vessels. You could take this in the form of supplements or eat more potassium-rich foods such as bananas.

When to See a Doctor 

Since labile hypertension can go undetected, it is important to get your blood pressure measured by your healthcare provider if you are experiencing any of the following symptoms:

• Fatigue
• Nausea
• Heart palpitations 
• Irregular heartbeats
• Shortness of breath 
• Lightheadedness or dizziness 
• Headache
• Excessive sweating
• Vision problems
• Confusion

If your doctor has prescribed medication to treat your blood pressure fluctuations and it is not improving, you should visit your doctor to discuss alternative treatment plans. 

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