Types of High Blood Pressure: All About Labile Hypertension

The Blood Pressure Condition the Medical Community Can't Agree Upon

taking blood pressure
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Labile hypertension, also sometimes inaccurately referred to as borderline hypertension, is a term used to describe those people who experience frequent changes in levels of hypertension, or high blood pressure. The condition is characterized by the sudden onset and ongoing fluctuations in blood pressure, which generally rise from a normal or healthy reading to a high reading at different times of the day.

Perhaps of most interest are the varied medical opinions about the condition that range from its characterization as an innocuous predecessor to more serious "fixed" hypertension to an inappropriate term for a common condition.

Medical Opinions About Labile Hypertension

While some in the medical community approach labile hypertension as a treatable condition, others believe that it is a faulty concept and diagnosis. No matter the camp in question, labile hypertension is generally believed to have less clinical significance than the better understood and more dangerous condition known as "fixed" hypertension. According to most medical experts, high blood pressure is of most concern when it is fixed or persists for long periods of time as its adverse effects on your health actually take many years to develop.

While most health care professionals are familiar with the term, there are no widely-accepted quantitative criteria to define or diagnose labile hypertension, which make guidelines for treatment and even understanding the condition all the more difficult.

That said, when a person's blood pressure is abnormally labile or variable, it is generally a symptom of another condition.

Causes of Labile Hypertension

Frequent changes in blood pressure can be the result of several factors, some normal and healthy while others are more serious. Those medical professionals who view labile hypertension as a faulty diagnosis point to the fact that just about everyone has labile, or varying, blood pressure - and they should.

According to the physicians at the Icahn School of Medicine at Mount Sinai in New York, blood pressure in a healthy person is continually changing in order to meet the needs of our bodies.

For instance, blood pressure naturally drops during periods of rest and sleep, while it rises during strenuous exercise. It is their position that while it is a common term, labile hypertension is generally an inappropriate way to characterize people whose blood pressure is truly unusually labile such is the case with many patients diagnosed with pheochromocytoma, or a rare tumor that originates in the adrenal glands cells.

Other physicians see a link between labile hypertension diagnoses with what is known as "white coat" or "office" hypertension, which are terms used to describe blood pressure readings that are only unusually high in the doctor's office or medical setting as a result of the anxiety that is common in those situations. Most cases of white coat hypertension show normal or healthy blood pressure readings at home before and after an office visit with a spike in blood pressure only while at the doctor's office.

That said, there are physicians who see signs of labile hypertension that are not necessarily attributable to a rare condition like pheochromocytoma or white coat hypertension. Much of the time, those varied changes in blood pressure are generally outside of the normal range of blood pressure and can often be linked to emotional stress. Symptoms of emotionally-driven labile hypertension can include headaches and ringing in the ears

Labile Hypertension Treatment

When unusual labile hypertension cannot be attributed to normal, healthy blood pressure changes or a rare disease or condition, many physicians will call for blood pressure monitoring over a 24-hour period as labeling a patient hypertensive after just one blood pressure reading is generally considered unwise. Monitoring blood pressure over the course of a full day can assist the physician in determining what percentage of the time the person is experiencing unnaturally high blood pressure. Along with a daily activity diary, the results of the monitoring can also help determine the cause of the blood pressure spikes. 

Unlike other high blood pressure conditions, most cases of labile hypertension do not respond well to conventional hypertension medications. Instead, for those people whose labile hypertension can be linked to emotional stress, the first step is to treat the anxiety, which can range from lifestyle changes like regular exercise and a healthy diet to relaxation techniques to anti-anxiety medications. 


"Hypertension Program Overview." Mount Sinai Doctors Faculty Practice. Icahn School of Medicine at Mount Sinai, 2015.

"Labile Hypertension: A Faulty Concept? The Framingham Study." The American Journal of Cardiology 43.2 (1979): 419.

Mann, Samuel J. "The Clinical Spectrum of Labile Hypertension: A Management Dilemma."The Journal of Clinical Hypertension 11.9 (2009): 491-97.

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