Hello, Thank you for your query. Based on his symptoms I would like to rule out heart disease and cervical spondylosis. would you clarify a few things for me, please? *does he have any other medical issues or take any medications? * is this the first time his pressure has gone high? *does he smoke or consume alcohol? * what are his height and weight? * does he have any other symptoms like breathlessness, unexplained sweating, fatigue? I recommend: - a physician consult - blood tests (complete blood count, lipid profile, blood glucose panel, kidney and liver function tests) - echocardiogram, electrocardiogram - x-ray of the cervical spine and chest x-ray. - a treadmill stress test if required. based on these a diagnosis can be made. please maintain a diary about his symptoms and trigger factors, how long it lasts, if he has any other symptoms (as mentioned above)and what relieves it. please seek medical help right away. Hope this helps. Please let me know if there is anything else I can help you with. Wish you both good health