What Is Labile Hypertension?

Medically Reviewed by James Beckerman, MD, FACC on June 30, 2023
4 min read

Your blood pressure regularly rises and falls, but if your blood pressure changes too much within minutes, this may be one of the signs of labile hypertension.

A blood pressure reading has two numbers. The first number represents systolic blood pressure, which indicates the amount of pressure your blood puts on the walls of your arteries when your heart beats. The second number represents diastolic blood pressure, which indicates the amount of pressure your blood puts on the walls of your arteries in between heartbeats.

Abnormalities in either of these readings can lead to a diagnosis of high blood pressure, but the systolic reading is often more important.

Having a high systolic reading puts you at a greater risk for cardiovascular disease over the age of 50. Your blood pressure naturally increases as you age because:

  • Your arteries become stiff
  • Plaque‌ builds up in your arteries
  • Your chances of getting cardiovascular diseases increase

The American Heart Association outlines five stages of blood pressure: normal, elevated, hypertension stage 1, hypertension stage 2, and hypertensive crisis.

Normal blood pressure. A normal blood pressure reading is less than 120/80 mmHg. Here, “mmHg” stands for millimeters of mercury because the traditional blood pressure gauge — called sphygmomanometer — contains mercury used for measurements.

Elevated blood pressure. Elevated blood pressure is indicated by 120 to 129 mmHg systolic and less than 80 mmHg diastolic measurements. If you get either of these readings, your doctor will ask you to manage your blood pressure to prevent worsening your condition.

Hypertension stage 1. If your blood pressure begins to consistently measure between 130 and 139 mmHg systolic or between 80 and 89 mmHg diastolic, you’re in hypertension stage 1. Your doctor may recommend a specific diet and certain lifestyle changes to lower your blood pressure. If you have other cardiovascular risk factors, they may also prescribe a blood pressure medication at this stage before it worsens.

Hypertension stage 2. If your blood pressure consistently measures 140/90 mmHg or higher, you’re in hypertension stage 2. It’s very likely that you’ll be prescribed a blood pressure medication at this stage.

Hypertensive crisis. If your blood pressure reading ever exceeds 180/120 mmHg, your life may be in danger. As a precaution, make sure you measure it again in five minutes to see if it has become lower. If it stays still high, you may be in a hypertensive crisis, and you need to seek immediate medical attention.

Hypertensive crisis is typically accompanied by symptoms like:

  • Chest pain
  • Shortness of breath
  • Back pain
  • Numbness
  • Weakness
  • Changes in vision
  • Difficulty speaking

Unusual, and sometimes unexplained, spikes in your blood pressure — called labile hypertension — may indicate something is wrong with your health.

Diagnosing labile hypertension is very qualitative. This means that this condition cannot be measured on any scale like the stages of hypertension are — there is no minimum number that your blood pressure has to spike and no minimum number of spikes that have to happen. It’s diagnosed depending on what your normal blood pressure range is. Signs of labile hypertension include:

  • Facial flushing
  • Tension headaches
  • Sweating‌
  • Feeling uneasy

Labile hypertension is usually situational. Spikes in your blood pressure happen in response to stressful life situations. Examples include:

  • A car accident
  • Financial problems
  • Intense physical activity‌
  • A disagreement with someone

High blood pressure is especially concerning if you develop it when you are in your teens or early twenties or you are over the age of 60. While it still requires medical attention, it’s more common to develop high blood pressure in your 40s, especially if you have a family history of high blood pressure. Regardless of age, your doctor will try to distinguish between true hypertension and labile hypertension concerns.

Your doctor will pursue a labile hypertension diagnosis by giving you a 24-hour ambulatory blood pressure monitor. If the results show unusual spikes in blood pressure, your doctor will search for the underlying cause.

If your doctor determines that a medication or a lifestyle choice is contributing to your labile hypertension symptoms, they’ll ask you to make changes in those to improve your health. They may also prescribe a different medication or suggest that you make changes like:

  • Quitting smoking
  • Drinking less alcohol
  • Eating a healthier diet
  • Losing weight‌
  • Exercising more

If you have an underlying medical condition that is causing labile hypertension, your doctor will treat that condition to help control your blood pressure for improved quality of life. Examples of such medical conditions include:

  • Sleep apnea
  • Cardiovascular disease
  • Kidney disease ‌
  • Adrenal glands problems

Many times these conditions cause damage before you even realize it’s happening. That’s why it’s important to talk to your doctor about any concerns you have regarding your blood pressure.