High blood pressure is a common health issue for many people. In the US, 47% of adults suffer from hypertension (higher than normal blood pressure).¹ While blood pressure can fluctuate throughout the day, a long-term increase can lead to serious health problems, including strokes and heart disease.
Temporary blood pressure spikes aren't always a cause for concern. However, knowing how to act can prevent unpleasant consequences. Let's look at what can cause temporary high blood pressure and what to do about it.
Blood pressure is the force exerted by your blood within your arteries, and the contraction of the heart muscle creates it.
The blood pressure is recorded by two numbers:
First (higher) number – systolic pressure – pressure in the arteries when the heart contracts.
Second (lower) number – diastolic pressure – pressure in the arteries when the heart is resting between beats.
Blood pressure can rise and fall throughout the day. However, it could signal a problem when blood pressure remains high for many hours.
According to American Heart Association, there are five blood pressure ranges:²
Normal – less than 120/80mm Hg
Elevated – 120–129mm Hg systolic and less than 80mm Hg diastolic
Hypertension (stage I) – 130–139mm Hg systolic or 80–89mm Hg diastolic
Hypertension (stage II) – at least 140mm Hg systolic or at least 90mm Hg diastolic
Hypertensive crisis – over 180mm Hg systolic and/or over 120mm Hg diastolic (if these levels hold, the person requires immediate medical attention).
A hypertensive crisis warrants immediate medical attention.
Blood pressure fluctuations are normal during the day. Blood pressure rises and falls in response to activities like sleeping, eating, or exercising.
Blood pressure also has a daily pattern. It rises a couple of hours before you wake up, increases during the day, and falls in the late afternoon and evening. The blood pressure peaks at midday and reaches the lowest point at night.
Accordingly, if your blood pressure is slightly higher in the morning than in the evening, it shouldn't be a cause for concern. However, a morning blood pressure spike is a cardiovascular risk.³
Temporarily high blood pressure is a blood pressure spike. For example, you suddenly start experiencing symptoms of high blood pressure that can include:
Pounding in ears, chest, or neck
You measure the blood pressure and see 140/90mm Hg. When you measure it again in half an hour, the blood pressure goes down to 120/80.
It's worth noting that many people don't experience any symptoms of high blood pressure. So you may not even notice a spike when it occurs.
Although sudden increases in blood pressure might seem concerning, this may not always be the case. If it's connected to a certain activity or situation and resolution of the problem normalizes the blood pressure, you may not need medical assistance.
If blood pressure fluctuations aren't within normal range and occur regularly, you may have labile hypertension.
Labile hypertension causes your blood pressure to fluctuate from high to normal frequently. While there isn't any treatment designed specifically for labile hypertension, medical professionals usually focus on helping patients avoid triggers.
If you measure your blood pressure and see elevated numbers, don't panic. There are a lot of causes for sudden spikes in blood pressure. This includes thyroid issues, scleroderma, collagen vascular disorder, and even overactive adrenal glands. Other causes that lead to normal physiological changes lead to blood pressure spikes. These include:
Your blood pressure may spike if you cut your finger when making dinner, stubbed your toe, or pinched a nerve.
Acute pain signals the hypothalamus and the pituitary gland to release adrenocorticotropin hormone (ACTH). This hormone, in turn, stimulates the adrenal glands, which release adrenaline. High adrenaline levels increase your blood pressure.
If you measure your blood pressure right after you get hurt, it will be high. However, as soon as the initial shock dies down, your blood pressure should go back to normal.
If the pain continues for several hours or days, the brain adjusts by releasing natural pain relievers into the body. They decrease sensitivity to pain. As a result, the blood pressure decreases.
Sudden blood pressure spikes can occur when you take certain medications, such as:
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen
Birth control pills
Meds with caffeine
Some herbal supplements with arnica and guarana
Illegal drugs (cocaine, anabolic steroids, amphetamines)
Your blood pressure should go back to normal as soon as the medication leaves your system. If the blood pressure remains high, it could signal a more serious problem.
A full bladder can easily raise your blood pressure by 15 or more points. Research shows that systolic and diastolic blood pressure increases if a person tries to hold the urine. After you go to the bathroom, the blood pressure goes back down.⁴
Many people experience blood pressure spikes at the doctor's office. If your blood pressure readings are normal at home but suddenly go up when the doctor tries to take them, you might be suffering from white coat syndrome.
The white coat syndrome is doctor-associated anxiety. When you visit a doctor, you naturally worry about your health, increasing your stress levels. Around 15% to 30% of people suffer from white coat hypertension.⁵
When you are in a stressful situation, your body goes into a fight-or-flight mode, producing stress hormones (adrenaline and cortisol). Your heart starts beating faster, and vessels begin constricting, and this causes a temporary blood pressure spike.
As soon as the stress reaction subsides, the blood pressure goes back to normal. If it doesn't, then you may have a hypertension problem.
When you exercise, your systolic blood pressure can go up. It's a natural reaction to an increased heart rate accompanying any workout.
If you measure your blood pressure right after a workout, you could see higher numbers than usual. During exercise, systolic pressure can rise to 250mm Hg or higher.⁶ The blood pressure should go back to normal within two hours.
Caffeine in food and medications can cause a sharp increase in your blood pressure. Scientists are yet to discover the exact reason why this happens. The level of blood pressure increase can vary from person to person.
Some researchers say that caffeine may be blocking the hormones responsible for keeping your arteries wide. Others believe that caffeine triggers adrenaline release.
The effect of caffeine can last for several hours.⁷ It can raise your systolic blood pressure by 3–15mm Hg and diastolic blood pressure by 4–13mm Hg. While it's not a dangerous increase, coupled with exercise or stress, coffee can spike blood levels significantly.
Smoking causes an acute rise in your blood pressure. Nicotine stimulates the release of catecholamine and vasopressin, and high levels of these hormones lead to high blood pressure.
The effect subsides after a while and returns when you smoke another cigarette. While a blood pressure spike is temporary, regular smoking could lead to various other issues with your cardiovascular system.
Tyramine is an amino acid that helps regulate BP. Your body produces it naturally but can also get it from food. Some foods like aged cheese, cured meats, and tropical fruits contain high levels of this amino acid.
When you ingest a lot of tyramine, it can trigger your nerve cells to release norepinephrine. This hormone increases your blood pressure. The blood pressure goes back down after tyramine leaves your system.
All the above causes of sudden blood pressure aren't dangerous in most cases. The blood pressure returns to normal as soon as the trigger goes away. However, if these spikes affect the quality of your life, you should still speak to a doctor.
If you measure your blood pressure and see high numbers, here are a few things you can do:
Calm down and lie down or at least take a seat
Start taking deep breaths or practicing other stress-relieving techniques
Eliminate possible triggers — extinguish your cigarette, stop drinking coffee, quit exercising, etc.
Take blood pressure meds prescribed by your doctor, if any.
Measure your blood pressure again in about five minutes. If it doesn't go down and you continue experiencing symptoms, consider calling your doctor.
If you experience a sudden blood pressure increase, you may need medical assistance. Here are a few reasons to call 911:
Your blood pressure is 180/120 or higher, and you have such symptoms as chest pain, severe headache, shortness of breath, weakness, vision problems, and difficulty speaking. These signs could be an indication of organ damage.
If your blood pressure isn't too high but doesn't return to normal for more than several hours, you need to speak to a doctor. A temporary blood pressure spike could signal the beginning of a more serious hypertension problem.
The first doctor you should contact is your primary care physician. They may refer you to a cardiologist.
It's possible to keep your blood pressure under control without medications. To do that, you have to rethink your lifestyle.
You can decrease your blood pressure by 1mm Hg by losing around two pounds. You also need to control your waistline. Excess visceral fat (the fat around your organs) can increase your blood pressure.⁸
Since stress is a common high blood pressure trigger, you need to learn how to manage it. While spikes may still occur, you can quickly get your blood pressure levels down with proper management.
Kick bad habits
Smoking and illegal drugs cause blood pressure spikes. Avoid them.
If your medications raise your blood pressure to a level where you experience discomfort, talk to your doctor about alternatives.
Blood pressure goes down when you sleep. If you don't get enough sleep, you could experience a blood pressure increase. People who get less than six hours of sleep per day feel a steeper rise in blood pressure.
Regular exercise strengthens your heart, helping it pump blood better and decreasing the pressure on your arteries.
Remember that high blood pressure isn't always obvious. Make it a habit to measure your blood pressure once or twice a month.
Normal blood pressure is an indication of your health. While it can fluctuate throughout the day, not all changes are within the normal range. When you experience a blood pressure spike, you could feel unpleasant symptoms. Fortunately, not all blood pressure increases warrant medical attention.
Causes of a sudden increase in blood pressure levels vary from full bladder to the wrong choice of food. However, if the blood pressure doesn't return to normal after the trigger is gone, you may need to contact your doctor.
Facts about hypertension | Centers for Disease Control and Prevention
New ACC/AHA high blood pressure guidelines lower definition of hypertension | American College of Cardiology
White-coat hypertension (2013)
"Exercise hypertension" occurs when cells can't "relax," Hopkins researchers find | Johns Hopkins Medicine
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