How much can blood pressure normally fluctuate?

Normal variations may differ by person. However, large variations may indicate a health condition. One study looked at patients taking blood pressure medicine. They found variations of more than 14 mm Hg in systolic pressure were associated with a 25% increased risk of heart failure.

What are the symptoms of fluctuating blood pressure?

You probably won't notice small changes in blood pressure unless you check it. If you have large fluctuations, you may have facial flushing, sweating, headaches, or an uneasy feeling.

Is It Normal for Blood Pressure to Fluctuate?

By Craig O. Weber, MD

Updated on December 04, 2021

Medically reviewed by Jeffrey S. Lander, MD

It's normal for blood pressure to vary somewhat throughout the day. Stress, exercise, and sleep can all make a difference. But if your blood pressure often changes significantly from one healthcare visit to another, there may a problem.

Studies have found that visit-to-visit changes in blood pressure are sometimes linked to a higher risk of heart disease and early death.

This article explains why your blood pressure numbers may be high sometimes and normal other times. It also offers advice about when to see a healthcare provider.

Causes of Fluctuating Blood Pressure — Verywell / Cindy Chung

Measuring Errors

First, it’s important to make sure that your blood pressure really is changing.

If you’ve used a home blood pressure cuff or the machine in a grocery store, the changes might actually be errors in how your blood pressure is measured.

Home blood pressure monitoring can be effective. But you need training to be sure you're using the equipment correctly. If you haven't been trained, your numbers could vary.

Drugstore machines—the kind where you to sit in a chair and put your arm through a cuff—are known for not being accurate.

To prevent errors, bring your home blood pressure monitor to your next healthcare appointment. Work with your doctor or nurse to be sure you're using it correctly. You should also bring your readings to see if you get similar numbers in the office.

Some healthcare providers recommend ambulatory blood pressure monitoring. That's where you wear a device at home. The device takes your blood pressure over a one- or two-day period. It checks every 15 to 20 minutes during the day and every 30 to 60 minutes at night.

This option isn't always available. Plus, it can be costly. The Centers for Medicare & Medicaid Services does cover this diagnostic test. But other insurance coverage can vary.

Medical Causes

Experts are exploring why blood pressure varies from visit to visit. It may be that people with blood pressure swings have a blood vessel problem. The ups and downs in their readings could be a clue that they're at a higher risk of having a heart attack or stroke.

Very rarely, blood pressure changes come from a pheochromocytoma—a tumor in the adrenal gland. These tumors are usually not cancer.

Medical Settings

Sometimes just being in a medical setting is enough to throw off your readings.

With white coat hypertension, a person's blood pressure is high at a healthcare provider's office, but normal when at home. Experts think the reason could be stress from being in a medical office. That's why nurses often wait for you to rest for five minutes before they take a reading.

Another option is to take your blood pressure twice. If there is a difference of more than 5 millimeters of mercury (mmHg), the readings should be checked again.

Masked hypertension is the opposite problem. It occurs when readings in a medical office are normal. Later, the numbers are high.

To sort these issues out, a healthcare provider may recommend home monitoring or ambulatory blood pressure monitoring.

Home monitoring may also be a good idea for:

Blood pressure readings that stay high even when medications increase
Blood pressure readings that stay low even when you take medication

High Blood Pressure

If you notice some high blood pressure readings among the normal ones, it could be that you have hypertension but have not been diagnosed yet.

Experts don't know exactly how high blood pressure develops. It may because your genes and your environment affect how your heart and kidneys work. It may also be due to gradual atherosclerosis, or hardening of the arteries.

Some risk factors raise the chances of having high blood pressure. They include:

Age (the chances go up as you get older)
Family history
Obesity
High-sodium diet
Not enough physical activity
Too much alcohol

Sometimes another health condition causes high blood pressure. That's called secondary high blood pressure because it happens as a result of a problem somewhere else in your body. Some medications can also cause secondary high blood pressure.

High blood pressure can come from :

Obstructive sleep apnea or other breathing problems
NSAIDs, antidepressants, and other medications
Endocrine and hormone disorders

Hypertension Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

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Summary

It's normal for your blood pressure to go up and down a little during the day. If you're using a home blood pressure cuff, the readings might be off. The same holds true for drugstore equipment.

It's also possible that your readings vary because you're stressed by being in a healthcare setting. If that's the case, your healthcare provider might ask you to use a device that tracks your blood pressure at home for a day or two.

It is possible that differences could be related to a health condition. If you're not getting consistent readings, it's important to see your healthcare provider about the issue.

A Word From Verywell

If you’re sure that your blood pressure readings are correct and the blood pressure swings happen even when you’re relaxed and well-rested, go see a healthcare provider. With proper monitoring, healthy habits, and medications (if needed), you can gain control over your heart health.

Frequently Asked Questions

How much can blood pressure normally fluctuate?

Normal variations may differ by person. However, large variations may indicate a health condition. One study looked at patients taking blood pressure medicine. They found variations of more than 14 mm Hg in systolic pressure were associated with a 25% increased risk of heart failure.
What are the symptoms of fluctuating blood pressure?

You probably won't notice small changes in blood pressure unless you check it. If you have large fluctuations, you may have facial flushing, sweating, headaches, or an uneasy feeling.

10 Sources

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