Why Even Occasional High Blood Pressure Is a Problem

Dr. Amir

Is your blood pressure sometimes high when you go to the doctor? Don’t ignore it. A new study shows that occasional high blood pressure readings may be worse than blood pressures that are consistently elevated – at least when it comes to the risk of stroke.

Occasional High Blood Pressure: An Increased Risk of Stroke?

Two different studies published in the journal Lancet showed that people with the highest systolic blood pressure readings - and the most variability in their blood pressure readings from doctor’s visit to doctor’s visit have a higher stroke risk – independent of their average blood pressure reading.

A third study looked at the issue of drugs used to treat hypertension and how they affect the risk of stroke. This study found that beta-blocker medications, commonly used to treat hypertension, increase blood pressure variability over time – and may carry a higher stroke risk than medications like calcium channel blockers which decrease blood pressure fluctuations and variability.

Occasional High Blood Pressure Readings Need Closer Attention

These studies could change the way people with occasional high blood pressures and fluctuating blood pressure readings are treated. The lead author these studies emphasized that it’s important to choose medications to treat hypertension that not only lower blood pressure, but do so without increasing blood pressure variability.

These latest findings may also affect how doctor’s look at people who have white coat hypertension – the phenomenon where blood pressure is higher when it’s checked in a doctor’s office and returns to normal after the patient returns home. People who have large fluctuations in blood pressure even when it’s due to stress may still have a higher stroke risk.

In general, beta-blockers aren’t usually a good first choice to treat hypertension for most people since they not only increase blood pressure variability over time, but have fewer benefits than medications such as ACE inhibitors – another commonly prescribed class of blood pressure medications. Beta-blockers have fallen out of favor as first line medications for high blood pressure.

Occasional Hypertension: The Bottom Line?

If you have occasional hypertension you could be at a higher stroke risk. Consider monitoring your blood pressure readings at home to see how much they vary on a day-to-day basis. Record them and take the record with you when you see your doctor - who can help you decide whether treatment is necessary.

References:

Medical News Today website. "Occasional High Blood Pressure May Pose Higher Stroke Risk:.
Cochrane.org website. "Beta-Blockers for Hypertension"

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