Dr Arif Mustaqueem Explains Everything About Labile Hypertension

Updated at: May 24, 2020
Dr Arif Mustaqueem Explains Everything About Labile Hypertension

Do you know that hypertension is one of the most prominent lifestyle ailments of the 21st century?

Tavishi Dogra
Other DiseasesWritten by: Tavishi DograPublished at: May 24, 2020

High Blood Pressure, we all know is high BP, higher than average. But the issue when it comes to the real-life scenario is complicated. Primary hypertension is when the cause is not identifiable. In secondary hypertension, the object can be attributed to something – genetics, lifestyle habits. Most of the time hypertension is a lifestyle ailment wherein a person has spent too much time-consuming processed foods, leading a sedentary lifestyle, consuming caffeine, alcohol, and tobacco in large amounts and being obese and unhealthy. Hypertension is stress-induced and can cause irreparable damage to the human body if not adequately treated. The question, whether the high BP is a “REAL” high BP which will require more diagnostic workup and maybe lifelong medical therapy or its just high BP owing to the environmental factors. Lots of time, when a patient enters Doctor’s chamber, if BP is checked immediately, there might be high BP because of anxiety, apprehension, or fear of being diagnosed with a chronic illness for the lifetime.

Dr Arif Mustaqueem, Senior Consultant, Interventional Cardiology, Fortis Escorts Heart Institute (FEHI), Okhla road, tell us about Labile Hypertension: one of those benign issues which disturb the patients more.

Also Read: Walking 10,000 Steps Daily Can Control Hypertension

  • The term 'labile hypertension' represents a clinical diagnosis in patients with considerable variation in their blood pressure readings. There is no exact definition; usually, the number is Systolic reading above 160 mm of Hg. Sympathetic nervous system involvement in blood pressure reactivity to environmental stressors is thought to be particularly relevant to the clinical entity of labile hypertension.

  • Labile hypertension is more likely to occur among anxious patients and patients under acute stress. It is also often identified among patients who frequently self-monitor their blood pressure (i.e., multiple times daily) or who tend to measure their blood pressure accurately when they believe it is elevated. Patients with labile hypertension experience recurrent episodes of transient blood pressure elevation. In some, blood pressure elevation can be substantial. Elevations are typically asymptomatic, although in some patients they can be accompanied by symptoms such as headache, palpitations, or flushing.

In addition to labile hypertension, diagnoses that should be considered among patients presenting with prominent episodic blood pressure elevations include pheochromocytoma, paroxysmal hypertension, and panic disorder, among others.

Provide counselling and reassurance, including the following measures

  • Reassure patients that, in the absence of high-risk comorbidity, transient, non-extreme blood pressure elevation is extremely unlikely to cause a stroke or other sudden cardiovascular event; instruct patients that it is normal for blood pressure to increase in moments of anxiety, and discourage patients from repeatedly checking their blood pressure at moments of distress. We generally avoid treating acute episodes with drug therapy.
  • However, in patients whose acute, episodic blood pressure elevations are associated with prominent symptoms, produce substantial psychologic distress or are severe (e.g., systolic blood pressure ≥180 or 200 mmHg and diastolic blood pressure ≥110 or 120 mmHg), and in patients who are at risk for complications from pronounced blood pressure elevation (e.g., known aneurysm, prior aortic dissection, symptomatic coronary disease), we suggest acute treatment to lower the blood pressure.

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