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Can cause of blood pressure spike be determined?
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Pianist4 posted:
I was with a 67 year old woman acquaintance with a history of high blood pressure who started getting light headed with severe jaw pain. I rushed her to her doctor who said her blood pressure was well over 200 and was in danger of a stroke. She was taken by ambulance to the hospital. After 2 days her bp was lower but still unstable. On a subsequent visit to her cardiologist she was told that her crisis was "definitely caused by stress and not a physical defect". My question is, can a doctor really say that with any degree of certainty? She had not reported being under stress. She is in good physical condition. Thank you.
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cardiostarusa1 responded:
Hi:

Can cause of blood pressure spike be determined?

Sometimes yes, sometimes no (especially in cases where it is deemed "idiopathic", that is, no known cause).

"On a subsequent visit to her cardiologist she was told that her crisis was definitely caused by stress and not a physical defect".

"Can a doctor really say that with any degree of certainty?"

One would think so ONLY if the proper diagnostic tests have been performed and interpreted correctly.

The Basics

The complex human body is usually able to keep blood pressure (BP) within safe/acceptable limits, but sometimes changes in lifestyle, health, side effects from prescription drugs, or changes in metabolism, make this difficult. This can cause the BP to become consistently higher or lower than normal, or spike up and then drop down.

Compensatory mechanisms that control BP involves changing the diameter of veins and small arteries (arterioles), the amount of blood pumped out from the heart per minute (cardiac output), and the volume of blood in the vessels.

High BP, temporary or chronic, may/can be related to various heart disorders, kidney problems, and sometimes liver, or adrenal gland problems. One's susceptibility to develop it can even be caused by an imbalance somewhere within the body's precise regulating systems.

Normal resting BP in adults is under 120/80 with 115/75 or 110/70 considered as being optimal/ideal. Prehypertension is defined as systolic of 120-139 mmHg and diastolic of 80-89 mmHg. Stage 1 is systolic of 140-159 and diastolic of 90-99. Stage II is systolic of 160-179 and diastolic of 100-109. Stage III is systolic greater than 180 and diastolic greater than 110. Stage IV systolic of 210 and greater, and diastolic of 120 and greater.

Health dangers from blood pressure vary among different age groups and depending on whether systolic or diastolic pressure (or both) is elevated, and for how long.

Elevated blood pressure, isolated diastolic hypertension, isolated systolic hypertension and diastolic/systolic hypertension, increases the risk of cardiovascular disease, cerebrovascular disease, and renovascular disease.

High systolic blood pressure appears as a significant indicator for heart complications, including death, in all ages, but especially in middle-aged and older adults.

High diastolic pressure is a strong predictor of heart attack and brain attack in young adults and in those of any age with essential hypertension, high blood pressure from unknown causes, which occurs in the great majority of cases.

Also, pulse pressure is important, the difference between systolic and diastolic. Usually, the resting (in sitting position) pulse pressure in healthy individuals is 40 mmHg, give or take a bit. A consistently narrow (say 20-25 or less) or consistently wide (say 60-65 or more) pulse pressure is not good.

Best of luck to the 67-years-young woman acquaintance and you down the road olf life,

Take care,

CardioStar*

WebMD member (since 8/99)

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