Brief Answer:
please see details.
Detailed Answer:
Dear Sir
1. The usual causes for true fluctuations are neuropathies (nerve disorders especially affecting autonomic nervous system), alcohol,
kidney diseases with large fluid shifts,
pheochromocytoma, poor drug compliance, unusual physical or mental
stress.
2. Faulty technique of measurement may also be responsible. Any increase in physical / mental stress or activity leads to rise in blood pressure. Hence measurements when you are excited, in pain, in stress, immediately after exercise, after tea/coffee/
smoking are falsely high. They do not reflect actual control.
3. If most of the readings are towards higher side, one need to up-titrate the medication with a careful watch on "very low BP". He may also be subjected to 24 hours BP monitoring to get the actual control. A machine is fitted externally on the arm for 24 hour which periodically takes BP (after each 15-30 minutes). This is quite helpful in cases of large fluctuations.
4. Your internist must look into the medical causes of fluctuation as described above.
5. For
facial nerve, he should put his palm on angle of mouth on effected side and
massage it with a motion towards the ear on that side. for better clarification consult an
ENT specialist.
6. Avoid excessive stress/ alcohol/ smoking/ salt/ chutneys/ soups/ pickles. Make sure that drugs are taken at right time.
Feel free to discuss further for any clarifications.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention,
click here.