What is Blood Pressure?
Blood pressure is the force with which the heart pumps blood around your body. With each heartbeat, your heart pushes blood around your body, and this pushing causes the blood to put some force on the walls of the vessels in which the blood is carried. Healthy blood pressure allows sufficient oxygenated blood to reach your body, ensuring that each part of your body has enough oxygen to function properly and keep itself healthy.
Some people may be surprised to hear that blood pressure is likely to fluctuate throughout the day. This article will consider the causes for such fluctuations, as well as what changes you can implement if your blood pressure fluctuations are out of the norm.
How is Blood Pressure Measured?
Blood pressure is typically measured using a blood pressure machine at a doctor’s office or home by yourself. However, sometimes a doctor may request you to measure your blood pressure at home throughout the day, as such readings may be a better representation of your true blood pressure values since you may be feeling slightly stressed at a doctor’s office, and this will result in higher blood pressure readings. Two readings are required to measure blood pressure, and they are measured in millimetres of mercury (mmHg).1 These two readings are Systolic and Diastolic and are often confused, so let’s look at what exactly they are.
What does Systolic and Diastolic pressure mean?
Systolic pressure is the first (upper) value in blood pressure measurements. It measures the blood pressure when the heart is squeezing/contracting.1 Diastolic is the second (lower) value presented, and it measures the pressure on the blood vessels when the heart relaxes.1 Normal blood pressure is when the systolic pressure is under 140 mmHg and diastolic is under 90 mmHg. In contrast, high blood pressure is when systolic is over 140 mmHg and/or diastolic is over 90 mmHg.1
What Does “Blood Pressure Fluctuation” mean?
Blood pressure fluctuation is usually defined as the average blood pressure variation throughout the day.1 This can happen within a healthy and completely normal range throughout the day and is not a reason for concern. If, however, the blood pressure is out of the norm, for instance, when the pressure regularly spikes above average, it can be a sign of some underlying issue.2
What is Labile Hypertension?
Labile hypertension is a condition where blood pressure fluctuates to higher values and does much more than what is considered healthy. It can be asymptomatic or can happen alongside symptoms like headache, palpitations, flushing, changes in vision and difficulty speaking. It is quite difficult to diagnose labile hypertension as there is no set of standards that clearly define the boundaries of healthy blood pressure fluctuations.3 For this reason, a non-invasive 24-hour ambulatory blood pressure monitoring device is used to measure a person’s blood pressure fluctuations, and a doctor can investigate abnormal spikes to diagnose conditions such as labile hypertension.3
Causes of Blood Pressure Fluctuations
Normal blood pressure fluctuations can occur when the body responds to certain stimuli, such as:
- Physical activities (e.g. exercising)
- Adrenal issues (i.e., poor coping mechanisms with stress, changes in emotion, anxiety)
- Sleep deprivation
- Body position
- Diet (e.g., high salt and alcohol intake)
- Misuse of medication
- Pregnancy 4
- Changes in weather 5
Risk Factors
Risk factors for fluctuating blood pressure include:
- Taking medications such as nonsteroidal anti-inflammatory medication like ibuprofen, naproxen and celecoxib, oral steroids, oral contraceptives and medication used for attention deficit hyperactivity disorder (ADHD) 2
- Low physical activity
- Poor dietary practices
- Obesity
- Stressful/high-intensity lifestyle
- Smoking
- High alcohol consumption
- Irregular sleep patterns
- Misuse of medication 6
Diagnosis
An ambulatory blood pressure monitoring device may be used to diagnose and observe fluctuating blood pressure. It is a non-invasive device which you would wear for 24 hours, and the readings from it would allow a doctor to find abnormalities in blood pressure fluctuations.3
Treatment and Management
If a person does not have underlying heart conditions or has one but is correctly using prescribed medication, a doctor may recommend making lifestyle changes such as:
- Quitting smoking
- Drinking less alcohol
- Having a healthier diet
- Achieving a healthy weight
- Exercising more
- Making changes to daily life to reduce stress and anxiety levels or seeking support to help cope with them
- Initiating treatment of possible underlying conditions to improve overall life quality
Complications
Severe and untreated high blood pressure fluctuations may lead to complications in the following body parts: 7
- Arteries: cells of the arteries’ inner lining can be damaged by high blood pressure, making them less elastic 8
- Heart: there is an increased risk of heart failure
- Brain: increased risk of stroke
- Kidneys: these are affected due to arteries around them weakening, narrowing or hardening 9
- Eyes: these are affected due to blood vessels in the retina being damaged 10
Prognosis
You may be tested for labile hypertension or autonomic dysfunction by using an ambulatory blood pressure monitoring device and/or electrocardiogram. This can help the doctor determine the best way to reduce the risk of your blood pressure fluctuation hurting your health and decreasing your quality of life. For instance, you may be encouraged to make changes to your lifestyle, such as reducing stress sources in your life and taking more consideration over your sleeping, exercise and eating habits.
Summary
Blood pressure fluctuations are a normal human response to changing environmental factors such as exercise or stress, and they are no reason for concern in most situations. However, if you believe your blood pressure fluctuation is out of range with what seems healthy, it is worth consulting your doctor. The doctor will assess whether your symptoms indicate any underlying condition, such as labile hypertension. If so, you may be provided with recommendations on reducing stress and improving your lifestyle habits. The Klarity app is a great way to navigate and observe your health and well-being changes, making it a great resource to take your health into your own hands.
References
- What is blood pressure and how is it measured? [Internet]. Institute for Quality and Efficiency in Health Care (IQWiG); 2019 [cited 2022 Oct 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279251/
- Pay attention to blood pressure fluctuations [Internet]. Cleveland Clinic Health Essentials. 2019 [cited 2022 Oct 19]. Available from: https://health.clevelandclinic.org/does-your-blood-pressure-fluctuate-widely-heres-why-you-need-to-pay-close-attention/
- What is labile hypertension? [Internet]. Harvard Health. 2019 [cited 2022 Oct 19]. Available from: https://www.health.harvard.edu/heart-health/what-is-labile-hypertension
- Gupta HP, Singh RK, Singh U, Mehrotra S, Verma NS, Baranwal N. Circadian pattern of blood pressure in normal pregnancy and preeclampsia. J Obstet Gynecol India [Internet]. 2011 Sep 22 [cited 2022 Oct 19];61(4):413. Available from: https://doi.org/10.1007/s13224-011-0062-3
- Aubinière-Robb L, Jeemon P, Hastie CE, Patel RK, McCallum L, Morrison D, et al. Blood pressure response to patterns of weather fluctuations and effect on mortality. Hypertension [Internet]. 2013 Jul [cited 2022 Oct 19];62(1):190–6. Available from: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.111.00686
- Singh S, Shankar R, Singh GP. Prevalence and associated risk factors of hypertension: a cross-sectional study in urban varanasi. International Journal of Hypertension [Internet]. 2017 Dec 3 [cited 2022 Oct 19];2017:e5491838. Available from: https://www.hindawi.com/journals/ijhy/2017/5491838/
- How high blood pressure can affect the body [Internet]. Mayo Clinic. [cited 2022 Oct 19]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868
- CDC. High blood pressure symptoms, causes, and problems | cdc. Gov [Internet]. Centers for Disease Control and Prevention. 2021 [cited 2022 Oct 19]. Available from: https://www.cdc.gov/bloodpressure/about.htm
- How high blood pressure can lead to kidney damage or failure [Internet]. www.heart.org. [cited 2022 Oct 19]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-kidney-damage-or-failure
- High blood pressure and eye disease information | mount sinai - new york [Internet]. Mount Sinai Health System. [cited 2022 Oct 19]. Available from: https://www.mountsinai.org/health-library/diseases-conditions/high-blood-pressure-and-eye-disease
