What is Labile Hypertension & How To Deal With It?

The word labile refers to something that can change quickly and spontaneously.

Hypertension means a blood pressure of 130/80 mm Hg or higher.

Labile hypertension is where a person’s blood pressure is not constantly within normal ranges, but also not constantly high either.

Symptoms

Although not everyone with labile hypertension will have symptoms, a person may experience:

• ringing in the ears, also known as tinnitus
• heart palpitations
• headache
• dizziness
• flushing
• general weakness or lethargy

Causes

Anxiety and stress can cause labile hypertension. An example of a situation that could cause this could be having just received some bad news, or waiting for exam results.

Many other factors can influence blood pressure too, including:

• age
• eating too much salt
• consuming too much caffeine
• taking certain prescription medications
• drinking alcohol
• drug use

Similar conditions

There are a few other conditions similar to labile hypertension in which blood pressure fluctuates beyond normal parameters.

Whitecoat hypertension

Whitecoat hypertension (WCH) is a condition in which a person’s blood pressure fluctuates in a medical setting. For example, it may only increase when they are at a doctor’s appointment.

If a person has WCH, the blood pressure readings a medical professional takes may not accurately reflect that individual’s true blood pressure.

Masked hypertension

The opposite of WCH is masked hypertension, a condition in which a person’s blood pressure readings at their healthcare provider are normal, but maybe higher at other times.

With masked hypertension, the blood pressure reading a healthcare provider takes may be lower than the person’s actual average blood pressure.

Paroxysmal hypertension

A similar condition to labile hypertension is paroxysmal hypertension. This may cause a person’s blood pressure to fluctuate dramatically between normal and high.

According to an older 2009 article, where labile hypertension is often situation-specific, usually due to stressful events, paroxysmal hypertension appears to be random.

Additionally, labile hypertension can be either symptomatic or asymptomatic, whereas paroxysmal hypertension typically presents with symptoms, including:

• headache
• flushing
• weakness
• palpitations
• a fear of death or stroke
• shortness of breath

The article suggests that paroxysmal hypertension is linked to repressed emotions that may be related to previous severe emotional trauma. It also notes that some people who experience paroxysmal hypertension may be prone to locking their emotions away.

In around 2% of cases of people with paroxysmal hypertension, the cause is related to a tumor known as a pheochromocytoma.

There is currently no treatment specifically for labile hypertension.

Medical professionals may instead focus on helping a person reduce situation-specific anxiety and stress.

They may prescribe short-term anti-anxiety medication for people to use only when they are experiencing symptoms of anxiety.

This medication could include:

• alprazolam (Xanax)
• clonazepam (Klonopin)
• diazepam (Valium)
• lorazepam (Ativan)

These usually help ease symptoms of anxiety within an hour, but they are not suited for a person to take long term because they become less effective the more often a person uses them.

The World Health Organization (WHO) warn that these types of medications also can become addictive if a person uses them for longer than 4 weeks. Thus, they are a short-term option.

Alternatively, healthcare professionals may prescribe long-term anti-anxiety medication that a person can take daily to help prevent anxiety.

This medication could include:

• sertraline (Zoloft)
• paroxetine (Paxil)
• escitalopram (Lexapro)
• citalopram (Celexa)

People experiencing labile hypertension might want to consider investing in a blood pressure monitor to use at home.

This may be especially useful for those experiencing white coat hypertension, as they can periodically take accurate readings of their blood pressure without having to go to their doctor.

Complications

A 2015 study found a correlation between labile hypertension and increased cardiovascular risks.

These included increased risks of:

• developing coronary heart disease
• experiencing a stroke
• experiencing heart failure

Diagnosis

There are no set criteria for diagnosing labile hypertension.

People experience fluctuations in blood pressure normally and there is no established threshold at which this becomes labile hypertension.

If a person also experiences WCH in addition to labile hypertension, a medical professional may think that the individual has constant hypertension, rather than labile hypertension.

If a healthcare provider suspects that a person may have high blood pressure, they may suggest using a blood pressure monitor at home to take regular readings.

If these usually indicate that the individual’s blood pressure is within a normal range, the healthcare provider may investigate further to rule out hypertension.

A doctor may recommend that a person undergo 24-hour ambulatory blood pressure monitoring to check if they are experiencing labile blood pressure.

This involves a person wearing a small device that records a variety of information from the body, such as time spent sleeping, when they eat, and periods of exercise. This can give a doctor a better picture of how a person’s blood pressure fluctuates throughout the day.

Prevention

A person seeking to minimize their risk of labile hypertension should consider:

• trying to control their levels of stress, avoiding stressful situations, or learning how to manage them more effectively
• managing their anxiety levels with meditation and other relaxation techniques, or through prescription medication
• giving up smoking
• limiting the amount of salt they consume
• limiting the amount of alcohol they drink
• avoiding using certain prescription medications or drugs

If a person experiences WCH, they can also try to reduce the stress associated with visiting a doctor so they feel calm and relaxed before the doctor takes their blood pressure.

Outlook

When a person’s blood pressure rises due to labile hypertension, they usually will not experience any issues, other than the potential symptoms that go along with it.

Their blood pressure will likely return to normal levels after a brief period of time.

However, there is evidence to suggest that long-term untreated labile hypertension can cause a person to have an increased risk of various health conditions.

When to see a doctor

Because untreated labile hypertension can cause an increased risk of health problems, and because the condition can be hard to detect, it is important for people to have their blood pressure checked regularly.

A medical professional can check a person’s blood pressure, or the person can purchase an at-home blood pressure monitor to regularly check it themselves.

Concluding Remarks

Even temporary increases in blood pressure levels can negatively impact a person’s body.

Regular increases can put a strain on a person’s heart and therefore increase their risk of mortality. That is why it is important for people to monitor their blood pressure and seek treatment if it is above normal levels.

Because labile hypertension is most often caused by anxiety, it is also important that people manage anxiety as best they can. Home treatments like meditation can help, and a person should also consider seeking the help of a medical professional.