Labile means easily changed. Hypertension is another term for high blood pressure. Labile hypertension occurs when a person’s blood pressure repeatedly or suddenly changes from normal to abnormally high levels. Labile hypertension usually happens during stressful situations.

It’s normal for your blood pressure to change a bit throughout the day. Physical activity, salt intake, caffeine, alcohol, sleep, and emotional stress all can impact your blood pressure. In labile hypertension, these swings in blood pressure are much larger than normal.

Hypertension, or high blood pressure, is defined as having a blood pressure of 130/80 mm Hg and higher. This includes those individuals with any top reading (systolic) 130 and above, or any bottom reading (diastolic) 80 and above. People with labile hypertension will have a blood pressure measurement of 130/80 mm Hg and over for a short period of time. Their blood pressure will then return to a normal range later on.

What causes labile hypertension?

Labile hypertension is typically caused by situations that make you anxious or stressed. For example, the anxiety people experience before a surgery. Eating foods high in sodium or consuming a lot of caffeine can also trigger a temporary increase in blood pressure above normal levels.

Some people have a spike in blood pressure only when they visit a doctor because they’re anxious about their visit. This form of labile hypertension is often called “white coat hypertension” or “white coat syndrome.”

What are the symptoms of labile hypertension?

Not everyone will have physical symptoms of labile hypertension.

If you do have physical symptoms, they may include:

  • headache
  • heart palpitations
  • flushing
  • ringing in the ears (tinnitus)

Labile hypertension vs. paroxysmal hypertension

Labile hypertension and paroxysmal hypertension are both conditions where blood pressure fluctuates widely between normal and high levels.

Paroxysmal hypertension is sometimes considered a type of labile high blood pressure, but there are a few key differences between the two conditions:

Labile hypertensionParoxysmal hypertension
usually occurs during emotionally stressful situationsseems to occur randomly or out of the blue, but it’s thought to be possibly caused by repressed emotions due to a past trauma
may or may not have symptomstypically causes distressing symptoms, like headache, weakness, and an intense fear of imminent death

A small percentage, less than 2 out of 100, of paroxysmal hypertension cases are caused by a tumor in the adrenal glands. This tumor is known as a pheochromocytoma.

Treatment options

There’s no set criteria for treating labile hypertension. Your doctor will want to monitor your blood pressure throughout the course of a day to see how often and how high it fluctuates.

Medications that are typically used to treat blood pressure, like diuretics or ACE inhibitors, may not be effective in treating labile hypertension.

Instead, your doctor may prescribe an as-needed anti-anxiety medication to help manage your event-related anxiety and stress. Examples of anti-anxiety medications used only for short-term and situational treatment of anxiety include:

  • alprazolam (Xanax)
  • clonazepam (Klonopin)
  • diazepam (Valium)
  • lorazepam (Ativan)

Long-term treatment of anxiety that requires daily medication would include medicines known as SSRIs, such as paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro), and citalopram (Celexa.)

Beta-blockers are medications used to treat other types of hypertension. These may be useful in both labile and paroxysmal hypertension as they interact with the sympathetic nervous system.

In these cases, beta-blockers are not used to lower blood pressure, but rather to reduce the symptoms associated with these conditions such as flushing, palpitations, or headaches. They’re often used in combination with anti-anxiety treatments. Examples of commonly used beta-blockers for these conditions include:

  • atenolol (Tenormin)
  • bisoprolol (Zebeta)
  • nadolol (Corgard)
  • betaxolol (Kerlone)

If you experience labile hypertension before having surgery or a medical procedure, these medications can also be given to you shortly before the procedure.

You may need to purchase an accurate blood pressure monitor to check your blood pressure periodically at home. You can find one at a medical supply store or a local pharmacy. Ask a store associate or pharmacist for assistance finding the correct machine to ensure you get an accurate measurement. Here’s a guide for checking your blood pressure at home.

It’s not recommended that you check your blood pressure every day since doing so can cause more anxiety about your blood pressure and make the problem worse.


In order to prevent future episodes of labile hypertension, you can try the following:

  • quit smoking
  • limit your salt intake
  • limit caffeine
  • avoid alcohol
  • manage your stress levels; exercise, meditation, deep breathing, yoga, or massage are all proven stress-reducing techniques
  • take anti-anxiety medication or other medications and treatments as prescribed by your doctor

At the doctor’s office, you may want to consider resting and breathing deeply for a while before having your blood pressure measured.


A temporary increase in blood pressure can put strain on your heart and other organs. If these temporary spikes in blood pressure happen often, it can cause damage to the kidneys, blood vessels, eyes, and heart.

Fluctuations in blood pressure can be particularly dangerous for people with preexisting heart or blood vessel conditions, like angina, cerebral aneurysm, or aortic aneurysm.

In the past, experts believed that labile hypertension didn’t carry as much concern as sustained or “fixed” hypertension. More recent research has revealed that untreated labile hypertension puts you at a higher risk of heart disease and death due to all causes, compared to those who are treated.

Along with heart disease, other studies have found that people with untreated labile hypertension are at increased risk of:

  • kidney damage
  • TIA (transient ischemic attack)
  • stroke


Labile hypertension usually doesn’t cause serious problems right away. Blood pressure typically returns to normal levels within a short period of time after the stressful incident.

Researchers now believe that untreated labile hypertension can cause problems later on. There is increasing evidence that it can increase a person’s risk of stroke, heart attack, other heart problems, and other organ damage over time if not treated.

Since labile hypertension is usually triggered by anxiety, it’s important to manage your anxiety with medications or relaxation techniques in order to prevent future or ongoing episodes.