Is fluctuating blood pressure more dangerous than high blood pressure?

Absolutely, yes. When we treat high blood pressure, we do not intend to bring it down aggressively, unless it’s an emergency, called a hypertensive emergency. Even in an emergency, we bring down your blood pressure carefully while we monitor it. A drastic, aggressive drop in blood pressure could be life threatening.

If you’re having drastic changes in your blood pressure, talk to your doctor about medication to carefully bring it under control and then keep it stable. Then, make lifestyle changes to help your medication work even better. You can help control your blood pressure by:

• Reducing the amount of salt you use: a daily intake less than 2.4 grams of salt will have an almost immediate lowering effect on your blood pressure
• Eating a healthy diet
• Exercising
• Avoiding caffeine and cigarettes
• Drinking 1 glass or less of alcohol per day if you’re a woman, 2 glasses or less per day if you’re a man

Fluctuating blood pressure and continually high blood pressure are equally dangerous. Both can lead to long term bad outcomes like stroke, heart attack, kidney failure and blindness.

One of the other causes for a Fluctuating Blood Pressure is a non-malignant tumor or tumors of the parathyroid gland - NOT the thyroid gland. As many as 75% of patients with parathyroid disease will have high blood pressure (hypertension). Sometimes it is hard to control and the patient has been put on 2, 3, and sometimes 4 drugs in an attempt to control it. Sometimes it's just one blood pressure drug, but at a time in the patient's life when blood pressure problems should not be showing up. The good news, however, is that fixing the parathyroid problem (having the little parathyroid tumor removed) will make the blood pressure problem go away completely or get better in almost everybody. You can find more information at: http://www.parathyroid.com/parathyroid-symptoms.htm.

We know that hypertension, not controlled, is a significant risk factor for heart disease and stroke. The question of fluctuating blood pressure is interesting. A person’s blood pressure does fluctuate during the day depending on your activity level. During exercise the blood pressure may rise as high as 230 mm on the systolic and 100-110 mm on the diastolic. However, this will return to the normal range as soon as the exercise stops. And while you are asleep, the blood pressure may go lower than normal, which is normal.

There are cases when fluctuating blood should be of concern. If someone is not taking their blood pressure medications correctly, this can lead to fluctuations. Also, there are medical illnesses that can lead to fluctuating blood pressure (i.e. Pheochromocytoma, Diabetes, and Autonomic nervous system diseases). The amount of time that blood pressure is elevated also increases the risk of heart disease and stroke. There is a study in the Archives of Neurology, May 2010, demonstrating that persons with high blood pressure who had large fluctuations in their pressures were at increased risk of Stroke and other cerebrovascular diseases.

So, I would recommend that if you are suffer from hypertension, whether continuous or fluctuating, that you seek medical treatment to prevent further injury to your body. 

Blood pressure that fluctuates or varies widely increases the risk of having a stroke, especially if the variations are occurring within a 24-hour period. This puts huge sudden stress on your arterial system. The “high blood pressure” stresses and weakens the walls of arteries, and then when the blood pressure suddenly drops, not enough blood moves through the arteries, which is when a blood clot and subsequent stroke can occur. Elevated blood pressure is often called silent hypertension because symptoms can remain unidentified until you have a true health crisis, like a stroke. If you are not regularly screened, you may never know that you have high blood pressure.