Question: Sometimes, I experience very high blood pressure when I'm anxious, like when I go for a medical visit. I have had readings as high as 190 that go down later.
ometimes, I experience very high blood pressure when I'm anxious, like when I go to a doctor's appointment. I have had readings as high as 190 that always come down when again checked later. My average reading when I'm relaxed is about 125/80.

But it has gotten so that I'm afraid to have my blood pressure because it will be high, then it becomes a self-fulfilling prophecy. I have had doctors prescribe blood pressure medications based on the readings in the office and it always makes my blood pressure drop too low outside of the office. Once I was taking 10mg of Norvasc and my BP dropped so low that I became lightheaded. I was taken to the ER and my bp was very low.

I'm a 46 year old African American female. I'm overweight and have mild asthma, but no other chronic conditions. I exercise on a regular basis. I have a family history of high blood pressure and heart disease, but both my parents are still alive, and my dad is in his 80's.

I take no medications on a regular basis. I have physicals every year and my metabolic panel, lipids and thyroid function are all normal. I am anemic at times. I've had EKG's which were all normal too. About 10 years ago I also had a test done where they collected my urine for 24 hours. I don't recall what it was for but they said that it was normal.

I've had this problem for as long as I can remember and I just don't know what to do. These BP spikes scare me. Is there anything you can suggest?

Dear Doctor,

Thank you for your prompt and thoughtful reply. One correction in my note I just turned 45, not 46, and I have been told I am peri-menopausal. I have irregular periods with a lot of physical and mood symptoms during my periods. Can hormonal imbalance cause blood pressure problems? It's just so frustrating because I have had this since I was in my twenties. I had a echo cardio gram when I was 19 because of panic attacks. They didn't find anything. I have never had a stress test or holter monitor. What kind of cardiac problems can cause fluctuations like this in blood pressure? And is there anything else that can cause it? I'm afraid now that I will fear I have anything might be!