Fluctuations in blood pressure
Definition - What are blood pressure fluctuations?
The term blood pressure fluctuations means that the blood pressure assumes different values at different times. These can occur physiologically, i.e. naturally, as well as due to illness.
The physiological fluctuations in blood pressure include the fluctuations of the first and second order. The former are the different blood pressure values during systole and diastole. Second order blood pressure fluctuations describe the variability of blood pressure during inhalation and exhalation. Even at night or in stressful situations, the human circulation reacts with changes in blood pressure.
However, disease-related processes can also lead to fluctuations in blood pressure. These can lead to dizziness or even loss of consciousness.
causes
The naturally occurring blood pressure fluctuations include the first and second order blood pressure fluctuations. The heartbeat is divided into systole and diastole. The systole describes the tension phase of the heart and the phase in which the blood is ejected into the circulation. Diastole is the relaxation phase of the heart. If the blood pressure is measured, two values are given, for example someone has a blood pressure of 120/80 (spoken 120/80). These two values are systolic and diastolic blood pressure. The first value, the higher, is the systolic and the second, lower, the diastolic value. This physiological fluctuation between systolic and diastolic blood pressure is called the first order blood pressure fluctuation.
Second-order fluctuations in blood pressure are a decrease in blood pressure during inhalation and a renewed increase in blood pressure during exhalation. The duration of these fluctuations per cardiac cycle depends on the respiratory rate.
Another fluctuation in blood pressure during the day is the drop in blood pressure during sleep. Compared to the daily mean, blood pressure falls between 10-20% at night. If there is high blood pressure, this drop can pathologically not occur. People whose blood pressure does not drop by at least 10% at night are known as “non-dippers” and should be given high blood pressure therapy.
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It is also one of the physiological phenomena that blood pressure rises in stressful situations. If, for example, adrenaline is released, this causes blood vessels to constrict, which in turn increases blood pressure. This is used to provide the organs with more oxygen for a short time.
Another reason for blood pressure fluctuations can be so-called “orthostatic dysregulation”. This is a drop in blood pressure immediately after getting up that can make you feel dizzy. In the worst case, it can even lead to a brief loss of consciousness. This dysregulation can be caused, for example, by a neuronal disorder that prevents the vessels from contracting enough to maintain blood pressure after getting up. The blood then “sinks” into the lower part of the body. A lack of fluids can also be the reason for the drop in blood pressure, for example if one suffers from bleeding, vomiting or diarrhea.
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Other organic diseases can also lead to fluctuations in blood pressure. Especially those that lead to increased or decreased hormone production. For example, if there are fluctuations in blood pressure, the thyroid should be examined, as an overactive thyroid can also cause blood pressure fluctuations. There are also tumors that produce adrenaline, for example, which can then result in a "surge" in blood pressure.
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Arrhythmias such as atrial fibrillation can also cause blood pressure fluctuations. Here, the heart cannot pump enough blood into the body's circulation for a short time, which can be noticeable, for example, as dizziness.
Anesthesia can also cause blood pressure fluctuations as a side effect. This is because the circulation is controlled by drugs and machines during anesthesia. If the body has to take over these tasks again after the anesthesia has ended, it can take a certain time for the blood pressure to stabilize.
diagnosis
The diagnosis can be made in different ways. The focus is on measuring blood pressure. However, since a single measurement cannot make any statements about fluctuations in blood pressure, a blood pressure measurement should be carried out over a period of 24 hours. For this purpose, a blood pressure monitor is attached, which measures the blood pressure at regular intervals during the day and night. With the help of these so-called long-term blood pressure measurements, fluctuations can be recorded and it can be observed whether the blood pressure drops sufficiently during the night. It makes sense for the patient to write down what he has done at different times of the day in order to be able to understand why the blood pressure has behaved in this way. If, for example, there was an argument or other excitement occurred, the evaluator should know this, as this can possibly result in an increase in blood pressure.
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A so-called Schellong test can be carried out in order to be able to determine a disorder of the orthostasis, i.e. a drop in blood pressure after getting up. The patient's blood pressure is measured alternately in a lying and standing position.
I recognize fluctuations in blood pressure by these symptoms
Fluctuations in blood pressure can lead to a number of symptoms. Depending on the direction in which the blood pressure fluctuates, different sensations result. If the blood pressure is too high, it can lead to headaches or nosebleeds. However, these symptoms are more likely to occur with chronic high blood pressure. If the blood pressure rises in a stressful situation, for example after the release of adrenaline or also in the context of an overactive thyroid, this is often accompanied by a feeling of racing heart or increased sweating.
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A drop in blood pressure, on the other hand, is often presented as dizziness. Depending on the cause, this can occur immediately after getting up or in other everyday situations. The vertigo attack can go hand in hand with a "black vision". If the drop in blood pressure is so severe that the brain is briefly insufficiently supplied with blood, a loss of consciousness can also occur. This is usually only of short duration, as the head is fed with sufficient liquid again in a lying position, following the force of gravity.
therapy
The principle of treating blood pressure fluctuations is to eliminate the underlying cause. In many cases, adding fluids, either by increasing the amount of water you drink or using an infusion, can solve the problem. In addition, if a drop in blood pressure occurs when standing up, the person concerned can take care to get up slowly and activate the leg muscles in order to ensure that the blood is “pumped up”.
If bleeding is the reason for the drop in blood pressure, the focus is on finding the source of the bleeding and stopping the bleeding.
Duration and prognosis
No general statement can be made about the duration and prognosis of the blood pressure fluctuations. If there is an organic cause, for example an overactive thyroid, the blood pressure levels off again after the disease has been treated. In many cases, a lack of fluids is the reason for the fluctuations in blood pressure. Compensating for such a deficit can also resolve circulatory problems. Fluctuations in blood pressure are a natural reaction of the body in stressful situations. They come about through the release of hormones and are short-lived. Once the stressful situation has ended, blood pressure quickly returns to normal. However, if more serious diseases such as an aortic dissection are the cause of the problem, the prognosis depends heavily on how promptly a therapy is initiated. If there is massive blood loss, life-threatening damage can result if therapy is initiated too late.
Course of disease
The course of the disease can vary depending on the cause of the fluctuations in blood pressure. Physiological fluctuations in blood pressure, such as when breathing in and out, are usually not noticed. If the blood spills in the legs after getting up, this can lead to a brief feeling of drowsiness, as the body can take a few seconds to minutes to regulate the circulation. However, such fluctuations in blood pressure are usually only of short duration and in most cases have no disease value. However, if blood pressure fluctuations occur over a longer period of time, this can cause unpleasant symptoms such as headaches for the person concerned. The cause should then be investigated because, for example, there may be pathological hormone production.
How contagious is that?
Fluctuations in blood pressure are either a natural phenomenon or a symptom of a disease. As a symptom in and of itself, fluctuations in blood pressure are not contagious. However, the cause that is responsible for the fluctuations in blood pressure can be transmitted from person to person. In principle, all diseases that lead to fluid loss can cause a drop in blood pressure. Counter-regulatory measures by the body can then also cause blood pressure fluctuations. For example, if the underlying disease is viral or bacterial diarrhea, it can be contagious.
