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Anyone else experience huge swings in blood pressure?
Heart & Blood Health | Last Active: Dec 12, 2025 | Replies (17)Comment receiving replies
I, too, can get big systoloc pressure swings from 104 to 160 and sometimes a bit higher. I have a prescription for clonidine and I take that to bring it down. It comes down within an hour but usually faster.Those swings are typically in the afternoon from 2 pm to maybe 5 pm.
I used to see a primary care doctor where my bp would go from 110/55 approx to 180/95 just walking in his office. I have no clue why as it never occurred with any other pcp nor at Mayo specialist appointments. I stopped seeing this pcp. I felt it could be dangerous although his office was within a mile from my home and the CRNA was his daughter - a very sweet woman.
My dad had isolated systolic hypertension. High swings occurred when he went for clinical trial colonoscopies or colorectal polyp removals at the Univ of MN. They would call him back, probably hoping to enroll him in another clinical trial but his bp was always normal then.
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@hsminc Here’s a more detailed explanation as to what might be going on based on Epidemiological studies with this pattern. (Not my opinion).
Very high systolic spikes.
Low/normal diastolic.
Low resting heart rate.
History of possible small strokes.
Big BP swings throughout the day.
This kind of pattern can feel mysterious, but there are several well-known medical explanations.
1. Isolated Systolic Hypertension (ISH)
When the top number (systolic) is high but the bottom number (diastolic) stays low.
Common causes:
Stiff arteries.
Aging.
Longstanding untreated high blood pressure.
Aortic valve issues.
Thyroid problems.
Stress and adrenaline surges
Dehydration at times, then sudden rehydration.
Extreme spikes like 241 systolic are very dangerous — they put a person at risk of stroke.
2. Large Blood Pressure Fluctuations.
Big swings (e.g., 180 in the morning, then 108 in the afternoon) can come from:
Autonomic nervous system dysfunction
(the system that manages BP and heart rate).
Sleep apnea.
Anxiety-adrenaline surges.
Pain.
Stiff arteries + low diastolic.
Certain medications (beta blockers, calcium channel blockers, diuretics, etc.).
3. Very Low Heart Rate (Bradycardia).
Since you were an athlete, a HR in the 40s or even 30s can happen — but only if:
They feel okay.
No dizziness.
No fainting.
No pauses on heart rhythm tests.
However, when bradycardia is combined with high BP and episodes of neurological symptoms, doctors get concerned about:
Conduction system problems.
Sick sinus syndrome.
Heart block.
Medication effects (if they're on BP meds that slow HR).
4. Two “mini-strokes” (TIAs).
This strongly suggests blood pressure instability or possibly:
Atrial fibrillation episodes that haven’t been caught yet.
Carotid artery disease.
Very high systolic pressure damaging small brain vessels.
Even if there was “no damage,” TIAs are a major warning sign.
5. What this pattern could suggest medically:
I am NOT diagnosing— just listing the common possibilities doctors check:
A. Autonomic dysfunction:
This can cause wide swings in BP and low HR.
Examples:
Neurocardiogenic issues.
Dysautonomia.
Baroreflex problems after long-term hypertension.
B. Stiff arteries + low diastolic:
When arteries stiffen, systolic skyrockets but diastolic stays low. This is a classic pattern in older adults.
C. Aortic valve problems:
Aortic insufficiency or stenosis can cause very wide pulse pressures.
D. Medication effect.
If they’re on meds that slow heart rate, an already athletic heart can get too slow.
E. Thyroid or adrenal hormone imbalance.
These conditions can cause fluctuating blood pressure.
6. What should not ignore:
Any of the following are emergency symptoms:
Sudden weakness or numbness.
Slurred speech.
Sudden vision changes.
Chest pressure.
Passing out.
Heart rate consistently under 40.
BP over 180/120 with symptoms.
7. What could you do while waiting to see a doctor?
A. Blood pressure monitoring correctly.
Sit quietly 5 minutes.
Same arm.
Same time daily.
Take 2 readings and then average.
Avoid caffeine/smoking for 30–60 minutes.
B. Keep a simple log.
Doctors value>
Time of day.
BP + HR.
Symptoms.
Meds taken.
Sleep quality
Fluid intake.
C. Ask for these tests when seen:
These are standard in this situation:
EKG.
Holter or 2-week patch monitor (checks for heart blocks/AFib).
Echocardiogram (heart structure, valves).
Carotid ultrasound.
Kidney function + electrolytes.
TSH & thyroid panel.
Aldosterone & renin (if secondary hypertension suspected.
8. Bottom line
The symptoms are real, and the pattern does match several known cardiovascular/autonomic issues.
Nothing here sounds “imagined” — and with a history of very high blood pressure and possible TIAs, this deserves thorough evaluation, even if the healthcare system is slow.