What Causes Fluctuating Blood Pressure?

The majority of healthy adults have stable blood pressure. Although it may drop slightly at night and go up by a few points during the day, this is normal.

However, this is not the case for some people. For example, some people have different blood pressure recordings at different times of the day while others have high blood pressure during the night.

When blood pressure fluctuates by a few points and occurs on a rare occasion, this is of minimal importance. However, if the blood pressure fluctuates by 5-10 mmHg during the day or night, then this is not normal.

There are a number of reasons why blood pressure may fluctuate. They include,

  • Medications. People taking medications for other conditions may experience fluctuating blood pressure. This is particularly true of people suffering from depression or Parkinsons disease.
  • Fever. Fevers occur when your body is fighting infection. Typically your heart rate will increase and your blood vessels will narrow, resulting in fluctuating blood pressure.
  • Food Consumption. If you’re sensitive to particular foodstuffs, consuming them could cause your blood pressure to fluctuate. This is especially common in people with salt sensitivities. Likewise, caffeine is known to cause blood pressure to rise, so if you suddenly start drinking more than your normal amount, you shouldn’t be surprised if your bp spikes.
  • Existing Medical Conditions. A number of medical conditions can cause fluctuating blood pressure. These include,
      • Diabetes. Diabetes is a common cause of wide variations in blood pressure.
      • Obstructive Sleep Apnea. Individuals with obstructive sleep apnea often have wide fluctuations in blood pressure especially during the night.
      • Kidney Disease. This is a common cause of blood pressure fluctuations. It is related to the inability to clear the fluids out of the body and excess secretion of hormones.

Adrenal fatigue, which is often caused by stress and is commonly found in older people, causes blood pressure to fall.

Overactive adrenal glands, which can be triggered by events such as a sudden burst of physical activity, excitement or anger and are more typically associated with younger people, cause blood pressure to rise.

Fluctuating blood pressure is also associated with people who have either an overactive or underactive thyroid gland and individuals who have peripheral vascular disease.

The blood pressure fluctuations in the presence of a medical disorder usually disappear when the condition is treated. However, in people with peripheral vascular disease and chronic kidney disease, even if treatment is undertaken the blood pressure fluctuations may remain and eventually result in permanent hypertension.


What Are Risk Factors For Developing Fluctuating Blood Pressure?

There are some risk factors that can trigger or worsen fluctuations in blood pressure. They include the following:

  • Smoking
  • Working night shifts
  • Being obese
  • Having an emotional disorder like anxiety
  • Excess and prolonged stress
  • Not maintaining compliance with blood pressure medications or taking blood pressure medications that do not last for 24 hours.

If your blood pressure fluctuates, it is important to see a healthcare provider and have a 24-hour blood pressure monitoring test done. These devices provide a more accurate picture of your blood pressure throughout the day and night. The earlier the fluctuations are detected, the sooner treatment can begin.


Why Does Blood Pressure Fluctuate During The Day?

Blood pressure follows a circadian rhythm, i.e. physiological changes that follow a 24 hour cycle. So in the same way that most adults will sleep during the night and be awake during the day, their blood pressure also follows a natural pattern.

In most healthy adults, there is a slight variation in blood pressure during the day and night. It tends to be slightly lower while sleeping, starting to rise just before you wake and continues to slowly rise during the day, peaking at around noontime. Then just before evening, the blood pressure starts to drop.

These blood pressure changes are linked to many factors including hormones, physical activity and the food you eat. However, the fluctuations should be mild, no more than 25-30%, and of little consequence.

If your blood pressure fluctuates by more than this, it’s likey to be caused by another condition.

The most common condition associated with fluctuations in blood pressure is high blood pressure. When the blood pressure is poorly controlled or has not been well controlled for a few months or years, fluctuations are common.

The blood vessels in these individuals are overtly sensitive and will tighten or narrow with even minimal stress. For example, a person with wide fluctuations in blood pressure may have a blood pressure of 130/88 in the morning but at lunch time, the blood pressure may shoot up to 210/120 mmHg.

Such large variations are dangerous and could also be triggered by emotional or physical stress, anger, food intolerance and failure to take the blood pressure medications on time or taking too little of the dose. There are some individuals who are salt sensitive meaning that if they eat too much salt, the blood pressure immediately rises.

Other causes of blood pressure variations in young people could be use of illicit drugs like methamphetamine and cocaine.

Finally there is a medical phenomenon known as “white coat” hypertension. When these individuals go to see the healthcare provider they immediately become apprehensive and very anxious. This causes the blood pressure to rise. As soon as they leave the doctor’s office, the blood pressure comes back to normal.

If a doctor suspects that you may have “white coat” hypertension, he or she may put a 24-hour monitor on you and record your blood pressure while you are at home. In addition, the doctor will also ask you to record your own blood pressure and write down the numbers. If the blood pressure number at home is consistently normal, then you have “white coat” hypertension.

While in most cases the blood pressure shoots up, there are also some conditions when the blood pressure may drop. This can also be a reason for blood pressure fluctuations and includes things like alcohol consumption, exercising in a warm environment and taking high doses of water pills.

Evidence now shows that people who have wide fluctuations in blood pressure during the day will not only go on to develop permanent hypertension but are also at risk for developing heart disease and a stroke.


How To Treat Fluctuating Blood Pressure

The treatment of fluctuating blood pressure depends on how high the levels go up and the frequency at which they do so. For example, if the blood pressure only goes up by a few points and is a rare event, then no treatment may be necessary. However, if the blood pressure goes up by more than 10 mmHg (upper number) or 5 mm Hg (lower number), then treatment is necessary, especially if this is a consistent observation.

If the fluctuating blood pressure is not treated, then the individual will likely develop permanent hypertension in the future.

Most healthcare providers will treat fluctuating blood pressure aggressively because it can be cured without medications. Some of the treatments for fluctuating blood pressure involve the following:

  • Exercise. Exercise of some type is highly recommended. The type of exercise you do is irrelevant, just choose something that you like so that you remain motivated.

You could start with something as simple as a walk. To be beneficial you’ll need to walk at a brisk pace for 45-60 minutes, 5-7 days a week.

Other activities include swimming, cycling, jogging and even aerobics.

Most people start to see the blood pressure stabilize after 6-8 weeks of regular exercise. However, it is important to continue the exercise even after the blood pressure has been lowered.

  • Diet. It is important to eat a balanced diet. This consists of fruit, vegetables, cereals, whole grains, and low fat dairy products. Saturated fats and processed foods should be kept to a minimum.

It’s also important not to exceed a calorie intake of 2,000 calories per day, unless of course you’re also doing significant exercise.

Decreasing the amount of salt in your diet will also help reduce your blood pressure. Salt hampers the kidneys ability to remove water. The extra fluid that remains in the body puts pressure on the blood vessels and results in blood pressure increasing. Salt intake should be limited to no more than 1,000 mg per day.

The best diet that is recommended for people who have borderline high blood pressure is the DASH diet. The diet has no restrictions on what you can eat but does encourage less salt and higher proportions of fruits and vegetables.

  • Smoking. It’s well established that over time most smokers go on to develop high blood pressure. So the best thing you can do is to stop. Even though there are many medications available to help you stop smoking, cold turkey appears to be the most effective method.
  • Alcohol. Limit the amount of alcohol per day. One should not drink more than a glass of wine a day. Because alcohol consumption can quickly get out of control, complete abstinence is recommended. The health benefits of alcohol are mild and can easily be substituted with exercise.
  • Stress. It is well known that stress can cause a rise in blood pressure, so take measures to reduce your stress level. Performing deep breathing exercises, yoga, meditation or gentle exercise like Tai chi are good things to do. If you perform these exercises regularly, you will notice a gradual stabilization of your blood pressure.

Fluctuating blood pressure can be cured but you will need to make drastic changes in your lifestyle. The benefits are that you will not develop permanent high blood pressure and this means fewer visits to the healthcare provider and this results in minimal healthcare expenditure. So start today!

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