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What causes fluctuations in blood pressure readings?

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Posted on Mon, 20 Jun 2016
Question: Hi i am having very fluctuating blood pressure readings,
my problems started when Sept' 2015 when i had an unexplained illness that went on November, at the time i was having palpitations, and diarrhea, no appetite, and i lost 2 stone in 3 months living on fesubin drinks i also developed ulcerated sores on my chest and developed costocondritis , my own GPs thought i might have a pheocyotoma tumor but i had a two day urine test that showed it was 97 % negative, during a visit to the emergency services i was told i had contracted e coxsackie virus infection that was responsible for the costocondritis as you can see my medical history is complex, i am about to start Hep C treatment for 12 weeks with Harvoni and ribavirin. since last Sept' i have had palpitations on and off, For a few weeks the palpataions would make my BP drop from 130 -140 region over high 80s to 90s to 104 to 120iwsh over 70s region so i was not worried and i saw a cardiologist who told me this was ectopic, in the last 2 weeks the palpitations have stopped and my BP is often 140 over 90s ans in the last 2 days Ive had readings of 155 over 123 this morning, but also have occasional days when it is 115 up over 77ish
i have had a headache with these higher blood pressures and i was woken a few night ago with a electric pain in my head and flushing, i took my BP which was 167 over 97 in the middle of the night, some days my BP goes as low as 104 and i feel good, but over 130 i have a pain over the top of my head that feels like burning, i have a 24 hour ECG ordered on the 13th May but if its one of the days I'm having low blood pressure it wont show anything, i rely on the National Health in the UK and if it doesn't show anything, i wont get any more investigations and i will have to go ahead with the Hep C treatment, im grateful for the treatment but afraid if something is missed regarding my heart which is 140 over 86 right now and fluctuating to 157 over 100s my treatment will have to be stopped to find safe heart meds's as Harvoni can have serious contradictions with some heart meds, my sats drop to 85 at night also and i have to wear a monitor that wakes me because of my sleep apnea and mild COPD, i'm sorry this is so long but needed to give you a full picture as this is very complicate for me, can you give me any advice please i do not have the funds for any private treatment. ps i am also quite breathless walking and during costocodrosis flare ups thankyou XXXXXXX
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Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXX!

Welcome back on HCM!

I carefully passed through your medical history and would explain that it is very important, before deciding the best strategy to control your high blood pressure fluctuations to closely monitor your BP values for a couple of days, up to a week (several times daily), write down those values and reconsult with your doctor for concluding whether your average BP value is above 140/90 mmHg.

If such is the case, then you need an anti-hypertensive medical therapy.

Regarding your recurrent palpitations (ectopic heart beats) and your high blood pressure, my advise would be to carefully consider optimization of sleep apnea and COPD therapy.

The fact that you have decreased oxygen blood saturations, during the night, and at the same time you experience symptomatic (with headache) bouts of high blood pressure, this means that exacerbations of sleep apnea are directly responsible for increasing pulmonary and systemic vascular resistences, leading to high blood pressure.

Also, sleep apnea is considered an important triggering factor for cardiac arrhythmia.

Once properly controlled, your pulmonary disorders (copd and sleep apnea), will no longer exhibit any adverse implications on your heart rhythm and blood pressure.

So first of all, you need to consult with your attending doctor (internist or pulmonologist) to review your underlying therapy (for copd and sleep apnea).

Besides your inhalatory therapy, I would recommend discussing the possibility for application of respiratory assist devices, which can deliver certain ventilatory regimens (CPAP, BPAP, etc.) enabling in such way to maintain open your respiratory airways, decrease hypoxemia and avoid low oxygen saturations.

This is the most appropriate strategy for relieving your frequent breathlessness and at the same time avoiding the potential for cardiac arrhythmia's and blood pressure fluctuations.

Only if after following the above mentioned strategy, the blood pressure continues to fluctuate again, it could be discussed about starting an anti-hypertensive therapy.

Hope to have been helpful!

If you have any other uncertainties do not hesitate to ask me!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

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Practicing since :2001

Answered : 8011 Questions

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What causes fluctuations in blood pressure readings?

Brief Answer: I would explain as follows: Detailed Answer: Hello XXXX! Welcome back on HCM! I carefully passed through your medical history and would explain that it is very important, before deciding the best strategy to control your high blood pressure fluctuations to closely monitor your BP values for a couple of days, up to a week (several times daily), write down those values and reconsult with your doctor for concluding whether your average BP value is above 140/90 mmHg. If such is the case, then you need an anti-hypertensive medical therapy. Regarding your recurrent palpitations (ectopic heart beats) and your high blood pressure, my advise would be to carefully consider optimization of sleep apnea and COPD therapy. The fact that you have decreased oxygen blood saturations, during the night, and at the same time you experience symptomatic (with headache) bouts of high blood pressure, this means that exacerbations of sleep apnea are directly responsible for increasing pulmonary and systemic vascular resistences, leading to high blood pressure. Also, sleep apnea is considered an important triggering factor for cardiac arrhythmia. Once properly controlled, your pulmonary disorders (copd and sleep apnea), will no longer exhibit any adverse implications on your heart rhythm and blood pressure. So first of all, you need to consult with your attending doctor (internist or pulmonologist) to review your underlying therapy (for copd and sleep apnea). Besides your inhalatory therapy, I would recommend discussing the possibility for application of respiratory assist devices, which can deliver certain ventilatory regimens (CPAP, BPAP, etc.) enabling in such way to maintain open your respiratory airways, decrease hypoxemia and avoid low oxygen saturations. This is the most appropriate strategy for relieving your frequent breathlessness and at the same time avoiding the potential for cardiac arrhythmia's and blood pressure fluctuations. Only if after following the above mentioned strategy, the blood pressure continues to fluctuate again, it could be discussed about starting an anti-hypertensive therapy. Hope to have been helpful! If you have any other uncertainties do not hesitate to ask me! Kind regards, Dr. Iliri