Blood pressure fluctuations during the day are normal and important to supply muscles and organs with sufficient blood. Only when long-term blood pressure shows conspicuous values, a medical clarification is necessary. Because a permanently too low or too high blood pressure is can be a symptom of another disease and represents a health risk for the affected person.
What are blood pressure fluctuations?
Pathological blood pressure fluctuations are diagnosed as hypertension, which is persistently high blood pressure, or hypotension, which is persistently low blood pressure. Blood pressure depends on a person’s age, diet, and body weight and is therefore an individually fluctuating value. Nevertheless, there are rough standard values for every age. For example, adult systolic blood pressure should be between 120 and 129 mmHg, and diastolic between 80 and 84 mmHg. In principle, it can be said that these values increase with age without being immediately alarming. Regular self-measurement is nevertheless advisable. Pathological blood pressure fluctuations are diagnosed as hypertension, the permanently high blood pressure, or hypotension, the permanently low blood pressure. These blood pressure fluctuations are defined on the basis of the systolic value, because the supply of the organs depends on it, while a too low diastolic blood pressure is less dangerous. If the systolic value is lower than 100, hypotension is diagnosed, and hypertension is defined from values of 140 to 90 mmHg.
Causes
The causes of blood pressure fluctuations can be physical and mental stress, coffee and caffeine consumption, and natural fluctuations during the day. For example, blood pressure is 10 to 15% higher in the early morning and late afternoon than at night, depending, of course, on the individual’s daily routine. The fluctuations thus caused are normal and unproblematic, as they quickly normalize. The triggers of manifest blood pressure fluctuations must be differentiated according to the specific disorder: Hypertension can be hereditary, but it can also be triggered by obesity, excessive salt intake, and stress. The possible causes of hypotension are underlying diseases, for example, naturally cardiovascular weaknesses, endocrine disorders, taking medications or lack of exercise.
Diseases with this symptom
- Obesity
- Heart attack
- Heart disease
- Arteriosclerosis
- Heart failure
- Anemia
- Stroke
- Hypotension
- Mental illness
- Diseases of the thyroid gland
- Hyperthyroidism
- Hypertension
- Pulmonary edema
- Aortic dissection
- Menopause
Diagnosis and progression
In particular, members of a risk group should regularly measure their blood pressure and keep a blood pressure diary. If there are longer lasting abnormalities, a doctor should be consulted. The first step is to measure the blood pressure. Several blood pressure and pulse measurements while standing and lying down and at different parts of the body allow an accurate assessment of the existing values. In a detailed anamnesis, the general practitioner will then reflect on the present symptoms, find out about eating habits, medication intake and risk factors, and discuss family history and psychological causes. A long-term measurement over 24 hours may also be necessary, as well as an exercise ECG and a visit to a cardiologist. The course of blood pressure fluctuations is critical if timely treatment is not given. Organ hypoxia, organ damage, and even death may then occur.
Complications
Blood pressure fluctuations during the day are perfectly normal; in fact, they are important for supplying muscles and organs with sufficient blood. Only when blood pressure is persistently too high or too low does medical attention become necessary. Blood pressure is not a constant value, it depends on diet, age and body weight. However, there are rough standard values, for example, a blood pressure of 120/80 mmHg should be measured in a healthy adult. At a higher age, these values naturally increase without posing a threat to the person. Blood pressure can also be measured regularly by oneself.Blood pressure fluctuations can also be triggered by physical activity; a lot of caffeine, for example, causes blood pressure to rise. But mental stress can also be the cause, blood pressure fluctuations are directly related to lifestyle. During the day, blood pressure is usually higher than at night, the fluctuations are not problematic and return to normal by themselves. Only when abnormalities become apparent should medical advice be sought. High blood pressure can also be hereditary, but usually there is simply a lack of proper nutrition or exercise. High and low blood pressure is treated with tablets and can be quickly brought under control, which of course does not mean that eating habits and risk factors should now be maintained. Sometimes a visit to the cardiologist is also necessary, because the heart can also be affected. Blood pressure disease must be treated, otherwise organs can be damaged and death can even occur.
When should you see a doctor?
When is a blood pressure fluctuation still within the tolerance range, and at what point are blood pressure fluctuations a reason to go to the doctor? In this regard, it should be known that blood pressure is constantly subject to fluctuations resulting from physical and psychological causes. In addition, blood pressure increases somewhat with age. It is also known that blood pressure increases after coffee consumption, which is perceived as invigorating. Blood pressure measurement is a routine check during a visit to the doctor. A slightly lower or higher blood pressure may be due to genetic factors. However, if blood pressure fluctuations occur over a longer period of time, a cause should be sought. Upward or downward fluctuations in blood pressure indicate a disordered blood pressure regulation. Physical diseases that can cause a rapid rise in blood pressure include kidney disease or incorrect medication settings. If the blood pressure suddenly drops, this is almost always due to a disease within the cardiovascular system and the use of certain medications. Thyroid dysfunction can also lead to blood pressure deviations: in the case of hyperthyroidism to a rise in blood pressure, in the case of hypothyroidism to a drop in blood pressure. It is also not uncommon for a rapid change from lying to standing to cause a temporary drop in blood pressure. However, blood pressure fluctuations can also be triggered by impaired self-regulation. Psychological causes are also worth considering. As a treating physician of blood pressure fluctuations, in addition to the family doctor, the internist, cardiologist, endocrinologist, neurologist, psychologist or psychotherapist can be considered.
Treatment and therapy
Treatment of blood pressure fluctuations depends on the severity and causes and must also be differentiated between hypertension and hypotension. Too low blood pressure does not need to be treated in every case, as it does not pose a threat to the organism. However, regular monitoring is necessary in order to detect further fluctuations in good time and to counteract them. If the doctor and patient decide on therapy, general measures such as avoiding physical exhaustion, relaxation techniques and a balanced diet are used first. Only if these do not help are drugs used to stimulate the circulation. The most important goal of high blood pressure therapy is to reduce the resting value to below 140 over 90 as quickly as possible and permanently. This is always achieved by drug therapy with beta blockers or diuretics; rarely, drugs are used that have an inhibitory effect on calcium levels or the protein ACE. Supportive efforts are made to minimize existing risk factors by reducing salt intake, aiming for a normal body weight, reducing alcohol consumption, and decreasing stress levels.
Outlook and prognosis
If blood pressure fluctuations occur, it is essential to seek medical attention. It is a serious symptom that must be treated without fail. If it is not promptly treated, the worst case scenario may result in a heart attack and eventually death. Small fluctuations are common during the course of the day. However, if larger fluctuations occur, they must be treated locally. As a rule, these blood pressure fluctuations are noticeable and lead to symptoms such as dizziness, headaches or a general feeling of illness. The treatment of blood pressure fluctuations is carried out by the cardiologist.The latter can often determine the cause, which in most cases is stress. Here, relaxation techniques and a healthy diet can help to reduce the fluctuations. If the blood pressure is generally too high, it must be lowered in any case. This is done mainly by abstaining from alcohol, unhealthy food and unnecessary stress. If the blood pressure is too low, no therapy is usually carried out if it does not pose a threat to the body. In most cases, blood pressure fluctuations can be treated relatively well and therefore do not lead to further complications or difficulties.
Prevention
Because of the many possible causes of blood pressure fluctuations, prevention is not always possible. A balanced diet, not too high in salt, and regular endurance exercise to achieve a reasonable blood pressure level are helpful.
Here’s what you can do yourself
Blood pressure fluctuations can be self-treated through a number of home remedies and self-care measures. First, stress and physical exertion should be reduced as much as possible to avoid high blood pressure and a subsequent drop in pulse. In addition, caffeine, alcohol and other stimulants, as well as fatty and heavy foods, should be avoided. Blood pressure can often also be stabilized through regular exercise and a generally healthy lifestyle with a balanced diet, sufficient sleep and plenty of exercise. Natural fluctuations in blood pressure can be reduced by various stress-reduction measures such as autogenic training or yoga. Effective home remedies include valerian, mistletoe or garlic. In addition, calming activities such as painting or handicrafts are recommended to reduce stress levels and thereby normalize blood pressure. However, those affected should first narrow down the possible causes of the fluctuations by keeping a diary and record the effectiveness of the measures mentioned. Blood pressure fluctuations that are accompanied by greater discomfort or even have a negative impact on general well-being must be discussed with the family doctor to clarify the cause. If the cause is known, targeted and rapid action can usually be taken against the fluctuating pulse.
