It is normal for your blood pressure to rise and fall throughout the day. Your blood pressure can fluctuate at any time due to various reasons.

It is normal for your blood pressure to rise and fall throughout the day. These fluctuations can be caused by everyday activities such as exercise, walking, and talking. However, if your blood pressure has spiked for no reason, it could be a sign of possible problems. 

Blood pressure refers to the pressure that blood exerts on the walls of your arteries. Arteries are the blood vessels that carry blood from your heart to other parts of the body.

When measuring blood pressure, you have to be aware of two numbers. The first is called systolic blood pressure. It represents the pressure in your arteries when your heart beats. 

The second is called diastolic blood pressure. It represents the pressure in your arteries when your heart is resting between beats. Therefore, should your blood pressure measurement show 120 systolic and 80 diastolic, that’s written as 120/80 mmHg.

If you have high blood pressure, your measurement will read anywhere between 130/80 mm Hg and 140/90 mm Hg or higher.

As mentioned earlier, your blood pressure can fluctuate at any time due to various reasons. There are also no clear criteria to tell between normal and abnormal fluctuations. However, there are a number of reasons why your blood pressure could spike suddenly. They include:

Whitecoat hypertension or alerting phenomenon. Sometimes blood pressure tends to rise just when you’re taking measurements. In most cases, it is due to anxiety associated with anticipated outcomes of the measurement. While this form of blood pressure spike happens at the doctor’s office, it can also occur when measuring at home. It may cause a vicious cycle of worrying, high measurement results, followed by more worrying and higher spikes.

Compared with people with normal blood pressure, a person who has white coat hypertension is at a significantly greater risk of developing sustained high blood pressure. The reason is that people with white coat hypertension may have a difficult time dealing with stress and anxiety. Your body releases stress hormones into the bloodstream. As a result, your heart beats faster, blood vessels narrow, and blood pressure spikes. It goes back to normal once the stressor or situation causing anxiety is over.

Labile hypertension. This is a condition that causes your blood pressure to spike to abnormal levels for a short period of time. The pressure then goes back to normal without intervention. Sometimes it’s due to emotional distress, particularly anxiety. However, other times there is no apparent cause.  

Paroxysmal hypertension or Pseudopheochromocytoma. Pheochromocytoma is a hormone-secreting tumor that can develop in the adrenal glands. It causes sudden fluctuations in blood pressure as well as irregular heartbeats. If you have this condition, your blood pressure will appear to spike for no reason. Less than 2% of people diagnosed with paroxysmal hypertension have a pheochromocytoma.

Certain medications can trigger abnormal blood pressure fluctuations. For example:

• Oral steroids
• Oral contraceptives that are high in estrogen
• Stimulants used in the treatment of attention deficit/hyperactivity disorder (ADHD)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Besides blood pressure measurement, there are other signs that could point toward a spike in levels. For instance: 

• Blurry vision
• Chest pain
• Shortness of breath
• Headache
• Coughing
• Nausea or vomiting
• Anxiety, fatigue, confusion, or restlessness
• Weakness or numbness in your arms, legs, face (sometimes signaling a stroke)

Since labile hypertension can be caused by side effects of medications, discontinuation can help relieve the condition. 

If you can, avoid frequent home monitoring, as it can lead to anxiety and elevated readings. It is, however, important to note that antihypertensive treatment does not reduce blood pressure fluctuations.

In dire cases, your doctor may want to treat you with anxiolytics, a class of medications used to prevent or treat anxiety symptoms or disorders.

Hypertension doesn’t occur suddenly. One of the signs that ought to prompt a visit to your doctor is unexplained blood pressure fluctuations. It will help you prevent further complications such as:

Heart disease. There’s evidence that people with blood pressure fluctuations are more likely to develop heart failure and stroke than people with normal blood pressure numbers.

Dementia. A study conducted in Japan found that people with blood pressure fluctuations were two times more likely to develop dementia and other mental problems than people with no fluctuation.

In most cases, hypertension is not discovered in time due to the absence of symptoms. That is why it’s important to pay attention to notable fluctuations in blood pressure. In addition, it helps to adopt certain lifestyle changes to ensure you have a healthy circulatory system. For instance:

• Eat a well-balanced diet that's low in salt
• Manage stress
• Limit alcohol
• Engage in regular physical activity
• Quit smoking
• Maintain a healthy weight
• Cooperate with your doctor 

The best thing to do once your blood pressure spikes is to try and calm down. Call your doctor to see if it’s necessary to schedule a visit. If your doctor thinks you should go to the health facility, you should do so, and if possible, carry any recently recorded measurements. Once in your doctor’s office, ask if you should wear an ambulatory blood pressure monitor which measures your blood pressure every 30 minutes for 24 hours.