Key takeaway

  • Labile hypertension involves frequent, dramatic fluctuations in blood pressure between normal and high. While occasional variations are natural, those with labile hypertension experience more extreme shifts.
  • Anxiety and stress are common causes of labile hypertension, but factors such as age, diet, medication, and substance use can also play a role.
  • There is no specific treatment for labile hypertension, but managing stress and anxiety with lifestyle changes or medication can help. Regular monitoring is also important due to potential cardiovascular risks associated with untreated labile hypertension.

While it is natural for a person’s blood pressure to vary throughout the day, labile hypertension causes blood pressure to fluctuate more dramatically.

This article explains what labile hypertension is, its symptoms and causes, how to treat and help prevent it, and when to see a doctor.

A person who may have labile hypertension checking their blood pressure.Share on Pinterest
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The word labile refers to something that can change quickly and spontaneously. Hypertension means a blood pressure of 130/80 mm Hg or higher.

Labile hypertension is when a person’s blood pressure is not constantly within expected ranges, but also not constantly high either.

There is no agreed-upon threshold or definition for labile hypertension. It is simply a descriptive term for a blood pressure with a wider variation.

Hypertension rarely causes symptoms, but some people may experience:

Anxiety and stress may contribute to fluctuations in blood pressure. An example of a situation that could cause this could be having just received some bad news, or waiting for exam results.

Although blood pressure fluctuations are expected, in labile hypertension the reaction may be more severe or frequent.

Many other factors can influence blood pressure, including:

There are no set criteria for diagnosing labile hypertension. People naturally experience fluctuations in blood pressure, and there is no established threshold at which this becomes labile hypertension.

If a healthcare professional suspects someone may have high blood pressure, they may suggest using a blood pressure monitor at home to take regular readings.

If these usually indicate that the person’s blood pressure is within an expected, “normal” range, the healthcare professional may investigate further to rule out hypertension.

A doctor may recommend that a person undergo 24-hour ambulatory blood pressure monitoring to determine what their blood pressure readings are throughout the day and night, giving a more accurate picture of their blood pressure and cardiovascular health.

This involves a person wearing a small device that records a variety of information from the body, such as time spent sleeping, when they eat, and periods of exercise. This can give a doctor a better picture of how a person’s blood pressure fluctuates throughout the day.

How to measure blood pressure properly

When measuring your blood pressure at home, use the following steps for an accurate reading:

  • empty the bladder
  • sit or rest for 5 minutes beforehand
  • sit in a comfortable, quiet room with support for the arm and back
  • sit with the legs uncrossed and both feet flat on the floor
  • position the monitor’s cuff over the bare midarm
  • keep the arm relaxed so the cuff is level with the heart
  • avoid distractions, such as talking or using other devices, while taking the blood pressure reading

Improper technique can lead to inaccurate readings and give an impression of labile hypertension when a person does not have it.

Below are a few other conditions similar to labile hypertension in which blood pressure fluctuates beyond expected parameters.

White coat hypertension

White coat hypertension (WCH) is when a person’s blood pressure fluctuates in a medical setting. For example, it may only increase when they are at a doctor’s appointment.

If a person has WCH, the blood pressure readings a medical professional takes may not accurately reflect that person’s true blood pressure.

Masked hypertension

The opposite of WCH is masked hypertension, a condition in which a person’s blood pressure readings at their doctor’s office are normal, but may be higher at other times.

With masked hypertension, the blood pressure reading a healthcare professional takes may be lower than the person’s actual average blood pressure.

Paroxysmal hypertension

A similar condition to labile hypertension is paroxysmal hypertension. This may cause a person’s blood pressure to fluctuate dramatically between normal and high.

According to a 2022 article, paroxysmal hypertension is typically symptomatic. It occurs seemingly at random and does not appear to link to a person’s emotional state or stress response.

The article suggests that paroxysmal hypertension links to repressed emotions that may be related to previous severe emotional trauma.

According to older research from 2015, the cause of paroxysmal hypertension is related to a tumor known as a pheochromocytoma in around 2% of cases.

There is currently no treatment specifically for labile hypertension. Medical professionals may instead focus on helping a person reduce situation-specific anxiety and keeping blood pressure in a healthy range.

A 2019 review suggests that doctors may prescribe antihypertensives, which are the mainstay of treatment for all types of hypertension.

Antidepressants and specific blood pressure-lowering drugs that target the sympathetic response, such as alpha- and beta-blockers, can also be useful.

If spikes in blood pressure link with feelings of anxiety, taking steps to manage anxiety may also help. This may include counseling, regular exercise, and relaxation strategies, such as yoga, breathing techniques, or mindfulness.

People with labile hypertension may want to consider investing in a blood pressure monitor to use at home. People should speak with their doctor about choosing a device that has been validated and fits appropriately.

This may be especially useful for those experiencing WCH, as they can periodically take accurate readings of their blood pressure without having to go to their doctor.

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Someone hoping to prevent labile hypertension may benefit from lifestyle habits associated with a lower risk of high blood pressure. This may include:

If a person experiences WCH, they can also try to reduce the stress associated with visiting a doctor so they feel calm and relaxed before the doctor takes their blood pressure.

When someone has labile hypertension, their blood pressure fluctuates more frequently or severely than typical. This condition does not usually cause symptoms, and blood pressure will likely return to normal levels after a brief period of time.

However, some evidence suggests that long term, untreated labile hypertension can cause an increased risk of various health conditions.

For example, a 2023 review highlights the correlation between blood pressure variability, which occurs in labile hypertension, and an increased risk of the following:

Since variation in blood pressure may increase the risk of health problems, and because labile hypertension can be challenging to detect, it is important for people to have their blood pressure checked regularly.

A medical professional can check a person’s blood pressure, or the person can purchase an at-home blood pressure monitor to regularly check it themselves.

If someone has high blood pressure, it is a good idea to work with a healthcare professional to monitor it and take steps to reduce it.

Labile hypertension involves regular increases in blood pressure from normal to high levels. People may not always have symptoms, but they may notice the variations during routine blood pressure checks.

Even temporary increases in blood pressure levels can negatively impact a person’s body. Regular blood pressure variation correlates with a higher risk of certain health issues, such as cardiovascular disease.

Since labile hypertension is often linked to anxiety, people may benefit from taking steps to reduce their stress. Home treatments such as meditation, yoga, and deep breathing can help.