Spikes in Blood Pressure
Q: Should I worry if my blood pressure briefly spikes to 180/100 millimeters of mercury and then returns to normal?
This is a situation that merits a check-up and a discussion with your doctor. Even if your blood pressure is normal 90 percent of the time, complications of high blood pressure can occur as a result of intermittent "spikes." Such blood pressure spikes can be a normal response to periods of emotional stress, or may represent the phenomenon known as "white coat hypertension." This condition is precipitated by an encounter with a health care worker wearing a white lab coat (my colleagues who do not don white coats tell me that they still frequently see blood pressure "spikes" during office visits). Alternatively, these blood pressure spikes could be a "marker" for the future development of sustained high blood pressure.
"Target organs" affected by either temporary or sustained hypertension include the retina, brain (risk of stroke), heart (risk of heart attack) and kidneys. One easy way to check for blood pressure spikes is to have a 24-hour blood pressure monitor, which is a device that you wear for a day and return to your doctor.
Your doctor will review your average blood pressure over a prolonged period of time and determine whether you require treatment. The challenge of starting patients on medications for intermittent blood pressure spikes is that the physician runs the risk of lowering the blood pressure too much when spikes are not occurring, and this can make you feel dizzy, tired or even pass out. Because of these issues, we often need to exercise a "trial-and-error" approach with medications.
Answered by: Robert N. Levin, M.D., Medical Director, Coronary Care Unit, Beaumont, Royal Oak