Blood pressure is one of the important parameters that should be monitored carefully. And often people with hypertension are worried about the situation when they notice surges in their blood pressure. Are they normal? He spoke about this on the air of the program “About the Most Important Thing” Alexander Myasnikov.
There may be a situation where the pressure is high in the morning, and in the evening it decreases. And sometimes all this is accompanied by arrhythmia. “Sharp fluctuations in pressure, when in the morning 150-160 mm Hg. Art., and in the evening it falls, it should not be, the body does not accept it. He is fighting against it,” said the doctor.
The body has a number of mechanisms to fight. Thus, in the area of the neck and collarbone, Myasnikov noted, there are baroreceptors. Their task is to keep the pressure at the same level. “Why we say: don’t let high blood pressure go untreated. As soon as the pressure has long been 140-150 per 90 mm Hg. Art., several weeks – they are reconfigured, they will already maintain this level of pressure as normal. You will take pills to lower it, but your body won’t let you. Baroreceptors will send a signal to the kidneys that everything is bad – the pressure drops, blood loss, the kidneys begin to produce a hormone that returns the pressure back to its 150 to 90 mm Hg. Art. This is why long-term high blood pressure is so difficult to break,” the doctor explained.
He also added that to assess surges, it is imperative to look at pressure fluctuations throughout the day. It is important for doctors to look at the daily and overnight averages. “During the day, the maximum pressure that we should have is 130 to 80 mmHg. Art. according to American standards and 135 to 85 mm Hg. Art. – according to European ones. Overnight the average should be 116 to 65 mm Hg. Art. by American standards and 120 by 70 mmHg. Art. among Europeans, everything higher is hypertension,” the specialist explained. Blood pressure should be lower at night – this is explained by the action of circadian rhythms. And if this is not the case, then you should be wary. To find out the average, it is enough to conduct daily Holter monitoring.
Could blood pressure surges be a sign of a panic attack?
This question arises if mainly the upper indicator is bouncing, plus the arms and legs are shaking and getting cold. “Whenever your hands turn pale, your heart beats, everything shakes, as a rule, this is a panic attack, and your blood pressure also increases,” said the doctor.
He recommended stopping measuring blood pressure for any reason. Of course, you should never refuse measurements, but you shouldn’t measure after any action or because you have nothing else to do. After all, the pressure level can depend on various parameters. For example, at home there is one measurement, but in the hospital the white coat syndrome is triggered, which leads to increased blood pressure.
Your blood pressure may increase if you leave treatment. 2/3 of hypertensive patients take 2-3 medications, sometimes they are combined in one tablet. And your blood pressure can jump if you stop treatment, start eating more salt, change your diet, or gain weight. The problem may also be that you are used to the medications and they stop working. “But you don’t change medications, you wait until the pressure starts to rise. And if it starts to sway, that’s already a bad sign. We will have to carry out all the treatment again,” the doctor noted.
According to medical recommendations, hypertensive patients should visit a specialist once every three months, regularly perform Holter monitoring, and, if necessary, select other medications.
Another cause of pressure surges can be orthostatic hypotension. For diabetics, Myasnikov emphasized, the standard situation is: the pressure is measured while sitting, and it is 110 to 80 mm Hg. Art. And after a couple of hours the person goes to lie down or sleep, and measures his blood pressure, and his blood pressure is under 200 to 110 mm Hg. Art. “Such people and those who have varicose veins should measure their blood pressure in two positions – lying down and sitting with their legs hanging down. Here the person sits down, and his blood pressure literally drops, as all the blood goes into the depot, and his pulse quickens. And this is dangerous, since a person does not receive medicine because his blood pressure is supposedly normal, and then he has a crisis,” Myasnikov noted.
How can you tell if it’s just a sharp rise in blood pressure or a hypertensive crisis?
“Hypertensive crisis is always the wrong treatment: either you forgot to take a pill, or you take the wrong pills, or you take them in the wrong dose, or you eat a lot of salt,” the doctor explained. He also noted that where hypertension is treated as expected, crises do not occur.
The only thing you need to remember is that during a hypertensive crisis, you cannot take a pill to quickly lower your blood pressure. After all, the consequences of this can be a sharp drop in pressure: in the brain – a stroke, in the heart – a heart attack, in the kidneys – kidney failure. Sometimes this measure is used by doctors in the emergency department. But there is always a specialist who will put in an IV in time, correct the situation and prevent the pressure from collapsing. This cannot be achieved at home. “If you have a question in this situation – to take a pill or not, it is better not to take it. Because maybe it will settle down on its own, you just need to lie down, darken the room, take a sedative, but under no circumstances bring down the pressure,” Myasnikov emphasized.
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