Fluctuating Blood Pressure: Should You Worry?

Can rise and falls in blood pressure harm heart health? Learn what your fluctuating blood pressure readings might mean here, including if there’s cause for concern.

Why does blood pressure fluctuate? What causes blood pressure to fluctuate from high to low? Although fluctuating blood pressure can be normal day-to-day, fluctuating beyond the normal range may be cause for worry. 

Keep reading to find out six reasons for changes in blood pressure (and when to worry). 

Why Does Blood Pressure Fluctuate?

Some blood pressure changes are normal. For example, before you wake up, your blood pressure begins to rise to support you in starting your activities for the day. For most people, blood pressure peaks in the middle of the day. 

Then, in the late afternoon and evening, blood pressure begins to drop. This helps to prepare your body for a good night’s sleep. 

Spotting Irregular Fluctuations

While some fluctuations are normal, other changes in blood pressure can be warning signs. Take note if blood pressure spikes: 

  • During the night
  • Early in the morning 
  • Suddenly and significantly
  • On a regular basis

Sudden and swift shifts in blood pressure are called labile hypertension. In other words, this condition occurs when your blood pressure experiences more fluctuations than is normal for your age. 

Additionally, other factors can affect blood pressure: 

  • Age
  • Alcohol, smoking, or recreational drugs
  • Body position
  • Caffeine 
  • Excessive exercise or inactivity 
  • Family history
  • Poor diet and meals high in salt (sodium)
  • Poor medication adherence 
  • Sleep disorders
  • Stress 

A doctor can help you track changes from visit to visit, and can help you cope better with expected changes in blood pressure (i.e. from sleeping to waking, during regular exercise). 

What Causes Blood Pressure To Fluctuate From High To Low?

There are many different potential causes of fluctuating blood pressure, but here are six of the most common ones. 

Heart Disease or Diabetes

Underlying blood vessel issues can cause fluctuations in blood pressure. Cardiovascular disease, kidney disease, and diabetes can all cause high blood pressure or changes in blood pressure. If you have diabetes, you may be twice as likely to have high blood pressure.

Cognitive Decline

Especially for the elderly, cerebrovascular disease can have detrimental effects. It’s important to recognize warning signs. Other less common conditions, like posterior reversible encephalopathy syndrome (PRES), can cause changes in blood pressure. 

Additionally, strokes are associated with changes in blood pressure numbers. Studies on blood pressure fluctuations in the elderly are continuing to find links between cognitive function and the complexities of blood pressure. 

Orthostatic Hypotension or Hypertension

Orthostatic hypotension (OH) and orthostatic hypertension (OHT) are forms of dysregulated blood pressure. While OH is typically linked to dementia, falls, and impaired Instrumental Activities of Daily Living (IADLs), OHT may also be the cause of problems. While OH and OHT are associated with different syndromes, both can affect the geriatric population. 

Hormone Disorders

In some cases, endocrine disorders or hormone problems can cause changes in blood pressure. Specifically, issues with the adrenal gland can cause issues with the way the body reacts. Essentially, your body’s system for “flight or fight” can get thrown off and affect your blood pressure. 

Injury, Illness, Infection, or Surgery

Blood pressure changes are common during situations like injury, illness, infection, or surgery. This is due to the physiological changes that occur. For example, a car accident cou

Changes In Medication

Changing medical regimens can also mess with blood pressure. Your daily patterns may change, so it is important to have your doctor walk you through what to look out for. 

While your pressure stabilizes, you can take careful steps to mitigate risk. Having a system for home monitoring can help you understand better how your medication is affecting your blood pressure. 

A Final Word On Fluctuating Blood Pressure

While changes in blood pressure don’t always cause immediate alarm, changes beyond the norm can introduce risk. It’s important to attend your regular doctor appointments and monitor your medication. Additionally, be sure to mention any other symptoms to your doctor to help them diagnose a root issue. 


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