Fluctuating Blood Pressure: Causes, Treatment, and More

While day-to-day fluctuations in blood pressure is often not a cause of concern, experiencing large variations paints a different story.


  • Blood pressure (BP) measures the force of blood against artery walls as the heart pumps it.
  • Though mild fluctuations in day-to-day blood pressures ensures a beating heart, large variations have been linked to a myriad of health concerns, including heart disease and cognitive decline.
  • Fluctuating blood pressures have numerous causes, including stress, prescriptions, and underlying health conditions.
  • To mitigate such risks, it is important to better understand the causes of blood pressure spikes and dips and how to manage them.
  • Regular blood pressure readings, lifestyle modifications, and medications can help control unstable blood pressures.

The Causes and Risks of Fluctuating Blood Pressure

Blood pressure (BP) measures the force of blood against artery walls as the heart pumps it. BP readings include both systolic and diastolic pressures.

Systolic pressure measures the pressure with each contraction of the heart, or heart beat, while diastolic pressure measures the pressure between each heart beat or pump. Blood pressure is read as systolic over diastolic (systolic/diastolic) with measurements written as millimeters of mercury (mm Hg).

Adults 65 and older are encouraged to manage blood pressure to the new treatment standard of <130/80 mmHg, which varies from the past, as the systolic pressure had been <140 for people younger than 65 and <150 for people 65 and older.

However, blood pressures can fluctuate caused by medications, a poor diet, underlying health conditions, and stress. Furthermore, a phenomenon known as white-coat hypertension, or a fluctuating blood pressure caused by worry or stress about a doctor’s visit, increases the risk of developing high blood pressure.

While blood fluctuations and spikes are not always a cause of concern, persistent unstable blood pressures have been linked to a host of health concerns, including heart disease and cognitive decline.

Heart Disease

In a study published in the Annals of Internal Medicine, researchers analyzed almost 26,000 study participants with high BP aged 55 years or older.

Over a 22-month time span, researchers measured the participants’ BP seven times to determine the amount of variability and were followed approximately 2.8 years to see who developed cardiovascular disease or passed away.

Researchers found the greater the variability in a participant’s BP readings before the follow-up period, the more likely the participant was to have had a poor health outcome, including fatal or nonfatal heart attack, stroke, or death related due to cardiovascular or other causes.

Cognitive Decline

Fluctuations in blood pressure have also been linked to faster declines in thinking skills among seniors.

A 2013 study published in the BMJ investigated the association between visit-to-visit variability in blood pressure and cognitive function in almost 5,500 participated over the age 70.

Higher visit-to-visit variability in blood pressure independent of average blood pressure was associated with impaired cognitive function, including worse performance on all cognitive tests focusing on attention, processing speed, and immediate memory.

Research published in Circulation and Hypertension has also linked unstable blood pressure to a faster decline in cognition and an increased risk of dementia.

Monitoring and Managing Unstable Blood Pressure

Monitoring Blood Pressure

Individuals should regularly monitor blood pressures to help identify not only high blood pressures, but pattern fluctuations in the readings.

The use of home monitoring system are valuable for both you and your caregiver allows to determine how effective current treatments are working and mitigate threatening health risks.

But just as important as using such monitoring systems, they need to be used properly to ensure the most accurate readings. Tips to accurately monitor blood pressure include:

  • Rest for at least five minutes before taking the measurement, along with remaining still while taking it.
  • Take an average of two readings at least one minute apart.
  • Empty the bladder and avoid caffeinated drinks before measuring blood pressure.
  • Stay consistent on the times you take blood pressure.

Management and Treatment Options

Managing and treatment of blood pressures can be achieved by making lifestyle changes and complying to medications if they are prescribed.

Individuals are first encouraged to control blood pressure by making healthy lifestyle changes, with the inclusion of a nutritious diet, exercise regimen, stress management techniques, and adequate sleep. Smokers should also stop the habit, along with moderating alcohol intake.

Seniors and their caregivers can also utilize Silver Cuisine, an a la cart meal delivery service supplying heart healthy and low-sodium meal options directly to your doorstep! All meals fall at or below the American Heart Association’s (AHA) recommendations for calories, sodium, total fat and saturated fat, with less than 600 milligrams (mg) of sodium and 3.5 grams of saturated fat. And beyond its nutritional value, each meal is overflowing with flavor to keep taste buds (and the heart) satisfied!

If making lifestyle changes and blood pressures are still uncontrolled, medications may be prescribed. Ultimately, though, consult with a primary care provider to determine a plan that works best for you.