Fluctuating blood pressure – the causes, preventions, and treatments

Last reviewed: 20 Jan 2022

Medically Reviewed By: Dr Jay Shah

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Everything we do in our day-to-day lives can affect our blood pressure, from commuting to work to exercising to not keeping hydrated. Those actions can lead to fluctuations in our blood pressure and they’re often brief, returning back to normal. But regular spikes and dips in blood pressure could be a sign of something more serious, and you should speak to your doctor as soon as possible.

In this guide, we’ll look at the various causes of fluctuating blood pressure, how to prevent it, and the different treatments available.


Here’s a quick summary of the technical terms used in this guide:

  • Hypertension: the medical term for high blood pressure
  • Hypotension: the medical term for low blood pressure
  • White-coat syndrome: also known as “white coat hypertension,” this describes the phenomenon where someone’s blood pressure readings are higher than usual when checked in a doctor’s office 

Pheochromocytoma: a rare type of tumour that can grow in the adrenal glands cause excessive excretion of hormones, leading to high blood pressure and other symptoms.

What are the causes of blood pressure fluctuations?


Stress is a way for the body to defend itself when it feels threatened or is confronted with danger.

Chemicals like cortisol, norepinephrine, and epinephrine are produced, causing a variety of reactions including increased blood pressure.

However, excessive stress can lead to severe and chronic hypertension if left untreated or unchecked.


Certain foods and drinks can raise blood pressure temporarily such as caffeinated drinks (coffee, tea, carbonated beverages like Coca-Cola and Pepsi).

Tyramine, an amino acid found in the body that helps regulate blood pressure, can also be found in some foods, particularly foods that have been cured or pickled, citrus fruits, and alcoholic drinks that have been fermented (e.g. beer and red wine).

Pre-existing conditions

Conditions that can cause fluctuations in blood pressure include:

  • While all these conditions can cause fluctuations in BP, they are not all worthwhile to mention. I would probably list the following:
  • Diabetes, sleep apnea, kidney disease, thyroid disease, adrenal disorders, rheumatologic diseases.
Health condition Hypertension Hypotension
Pregnancy YES YES
Bradycardia NO YES
Addison’s disease NO YES
Hypoglycemia YES YES
Anaemia YES YES
Kidney disease YES YES
Diabetes YES YES
Sleep apnea YES NO
Hyper/hypothyroidism YES YES
Pheochromocytoma YES NO
Lupus YES NO




Studies have also shown that hypertension in midlife is associated with an increased risk of developing certain types of dementia or cognitive impairment in later life.


Certain medications, both prescription and over-the-counter, can also increase blood pressure such as:

  • Steroids
  • Anti-inflammatory medicines (e.g. ibuprofen and naproxen)
  • Recreational drugs, energy drinks
  • Some antidepressants
  • Decongestants such as pseudoephedrine (Sudafed) and phenylephrine
  • Some types of chemotherapies
  • Some immunosuppressive medications

How to prevent blood pressure fluctuations


The right exercise routine can level out blood pressure fluctuations. It’s recommended that people try to get at least 30 minutes of aerobic activity 4-7 days a week.

Read more about exercise and how it can lower your blood pressure in our guide.

Weight fluctuations

Our bodies change constantly as we grow up and grow older. But fluctuations in weight can cause both hypertension (particularly linked to obesity) and hypotension (due to significant and rapid weight loss, known as orthostatic hypotension).

The general advice is to avoid “fad” diets or diet pills that can cause dangerous weight loss and weight gain and put a strain on your heart and body. These behaviours may also cause emotional trauma around body image so it’s important to speak to a doctor if you have any concerns.

Changes in diet

Avoid tyramine-rich foods and replace them with low-tyramine foods and drinks such as:

  • Vegetables (leafy green vegetables are high in iron which can also help anaemia, another cause of blood pressure fluctuations)
  • All non-citrus fruits
  • Grains like cereal, bread, cereal, rice, and pasta
  • Fresh but low-fat dairy products (as well as dairy-alternatives like soy or oat milk)
  • Eggs
  • Fresh meat, fish, and poultry
  • Decaffeinated drinks

You should speak to a doctor or dietitian regarding cholesterol and calorie intake if they are deemed too high and causing blood pressure issues or related conditions.

Reduce stress

There are numerous ways to reduce stress in your life, such as:

  • Exercising regularly
  • Using relaxation techniques

For more information, check out our guide to reducing blood pressure.

Blood pressure monitoring

Monitoring your blood pressure is paramount to maintaining a healthy heart. A blood pressure monitor can:

  • Catch fluctuations by the hour (depending on the device type)
  • Detect White-coat syndrome to ensure an accurate diagnosis
  • Keep tabs on the blood pressure or help identify conditions or factors that cause fluctuations

For advice on finding the right BP monitor for your lifestyle, check our BP monitor buying guide.

Available treatments


The following are some of the general categories of medications used to regulate blood pressure and treat hypertension:

  • Diuretics
  • Beta-Blockers
  • Calcium channel blockers
  • ACE/ARB Inhibitors
  • Alpha-blockers
  • Alpha-2/Centrally-acting Agonists
  • Peripheral Vasodilators

As always, please consult a doctor before taking any blood pressure medication and discuss the various options.


While regulating your blood pressure can be challenging, with multiple contributing factors, the benefits are significant to preventing significant blood-pressure related conditions in the future.

It’s recommended to stay in close contact with your doctor and talk to them about the different preventative measures available to you, including exercise, changes in diet, and stress reduction. And investing in a blood pressure monitor like Aktiia can help keep you and your doctor informed with accurate 24/7 blood pressure readings to inform your treatment plan.

Find out more about Aktiia’s clinically validated optical BP monitor can help you keep on top of blood pressure fluctuations.

Aktiia Team Written by The Aktiia Team

Our mission is to help people live free from hypertension.

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