Discussions By Condition: I cannot get a diagnosis.

spikes in blood pressure 260/120

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: illinifans
  • December 12, 2008
  • 03:41 AM

My father is 84 years old and has fought hypertension for as long as I can remember. For the last 2 years, he has experienced sudden spikes in his BP often reaching levels as high as 260/120. The spikes can be accompanied by angina and sometimes palpitations. He uses Nitroglycerin (multiple times) to relieve the pain and to help bring down the pressure, but it doesn't always work. This can occur when he is just sitting watching tv or even during his sleep. He has gone to the emergency room 5 times this year, each time spending a few days there until the pressure is brought under control. One of the visits when he was experiencing severe angina, a stent was placed in a major coronary artery, He does fine for about a month and then the cycle begins again. His doctors have placed him on several medications including Labetolol, Atenolol, Catapres, Hydrochlorothiazide and several others (not necessarily at the same time). He supposedly had his renal arteries checked and they were ok. He also has an adrenal gland with a tumor or cyst which was found by accident on a CT scan. Supposedly, this was also checked while in the hospital and they said the test was normal. I have my doubts. The doctors often seem like they don't know what they are doing. What could possibly cause these spikes. He is losing hope and does not want to go back into the hospital. Could this be a sign of some other underlying problem? Any ideas would be appreciated.

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  • My father is 84 years old and has fought hypertension for as long as I can remember. For the last 2 years, he has experienced sudden spikes in his BP often reaching levels as high as 260/120. The spikes can be accompanied by angina and sometimes palpitations. He uses Nitroglycerin (multiple times) to relieve the pain and to help bring down the pressure, but it doesn't always work. This can occur when he is just sitting watching tv or even during his sleep. He has gone to the emergency room 5 times this year, each time spending a few days there until the pressure is brought under control. One of the visits when he was experiencing severe angina, a stent was placed in a major coronary artery, He does fine for about a month and then the cycle begins again. His doctors have placed him on several medications including Labetolol, Atenolol, Catapres, Hydrochlorothiazide and several others (not necessarily at the same time). He supposedly had his renal arteries checked and they were ok. He also has an adrenal gland with a tumor or cyst which was found by accident on a CT scan. Supposedly, this was also checked while in the hospital and they said the test was normal. I have my doubts. The doctors often seem like they don't know what they are doing. What could possibly cause these spikes. He is losing hope and does not want to go back into the hospital. Could this be a sign of some other underlying problem? Any ideas would be appreciated. Does he have any other symptoms like dizziness, vertigo, numbness? Have they checked his thyroid thoroughly as oncontrolled thyroid issues can cause a spike in bp. What is his diet like? What does he eat and drink on a daily basis? Best wishesDOM
    acuann 3080 Replies
    • December 12, 2008
    • 04:14 AM
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  • It may be worth looking into his thyroid. I'll mention it to him. I'm sure his diet isn't the best, but he tries to limit salt etc. He has never been a smoker and does not drink any alcohol. The only other thing he experiences is that he can tell when the pressure is spiking. I think he said his heart will start beating real hard and he can feel it. There is no vertigo or numbness although he does complain of angina.
    illinifans 2 Replies
    • December 12, 2008
    • 04:22 AM
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  • The thyroid may be worth looking into. I'll mention that to him. His diet isn't the best, I'm sure, but he does try to limit his salt and meat intake. Also, he doesn't smoke or drink alcohol. During an episode, he feels his heart starting to pump very hard and may experience some angina. There is no vertigo or numbness.
    illinifans 2 Replies
    • December 12, 2008
    • 04:30 AM
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  • Although it's rare,a pheochromocytoma should be ruled out.It is a tumor of the adrenal gland,which you said had already been identified except for the specific type.A ''pheo'' can cause a sudden increase in blood pressure,associated with tremors and sweating.It certainly can cause palpitations,too.It's fairly easy to diagnose with appropriate lab tests.:)
    richard wayne2b 1232 Replies
    • December 12, 2008
    • 01:56 PM
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  • I forgot to mention that blood pressure control is difficult if not impossible in a ''pheo'' patient.Also,an overactive thyroid gland can cause similar symptoms.You can get the full differential diagnosis from a website,but be sure that he has been tested(or should be) by serum or urinary catecholamines.Good luck.:)
    richard wayne2b 1232 Replies
    • December 12, 2008
    • 02:10 PM
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