Why is blood pressure so erratic?

Hi @lp5, and welcome to Mayo Clinic Connect! Watching someone experience blood pressure changes can be concerning, and I’m glad you reached out.

There are several reasons blood pressure can fluctuate, starting with making sure the same blood pressure monitor is being used and that readings are taken under similar conditions each time. Because you mention your friend has been fainting, I would encourage her to contact her healthcare provider promptly to discuss both the blood pressure readings and the fainting episodes, even if her pacemaker has been checked and is working properly.

Has she noticed whether the fainting occurs when she stands up, after meals, during activity, or does it happen without warning?

@jmb73, @mayofeb2020, @concernedparent6dcs, @cpratt63 and @sspl1948, have any of you experienced blood pressure fluctuations or fainting with a pacemaker?

With those readings I don't believe it's the pacemaker. It's valvular possibly, not likely, or it's endocrine, probably kidney function. The kidneys play a major role in blood pressure regulation. In fact, this could even be dietary if we get down to the nitty-gritty and do a proper assessment. Nutrition might be deficient. So, this has to go to a medical authority for proper assessment.

@lp5
Pacemaker is not going to affect BP unless she is being paced all the time and the pacing could be set too low.

Most (HR and EP doctors I see) BP issues are from the hearts pumping capability, signs of cardiovascular disease, and medication and supplements.

Fainting is not good!! The diastolic (lower number) being around 60 can cause some problems in some who's heart may not be able to rise BP when you stand up real soon. When does she faint? What was she doing when she fainted. Standing up to quickly, climbing out of bed? All of those if not done slowly and your BP is low or have heart issues like heart failure can causes dizziness and fainting.

This are things she needs to talk to her doctors about and give all her medications she is taking and any supplements. Then go over the activity when she gets faint. It looks like systolic has the biggest change but it is not low just the distolic.

At 76 these issues arise much more often than when younger. I am 79 and have had a ICD/Pacemaker for over 20 years.

Please clarify, were any of the blood pressure readings taken just before or after fainting? If not, suggest to try to record BP when feeling faint.
Second question, does the patient have a long history of wide fluctuations in blood pressure, for example in visits to a clinic? Some patients systolic pressures go up 40 or more points when in a medical setting.
Agree with harsh above, try to list out situations where faint feeling occurs, along with the BP at the time.
Best wishes

As a retired nurse those BP readings you noted are not considered “all over the place” in my opinion. The diastolic readings are all within range. The systolic readings are a little off but we don’t know at what time these were recorded in relation to the fainting spell. It would not be unusual for readings to drop after an episode too. And a cardiologist could interpret the pacemaker to possibly identify a cause too.