Brief Answer:
Labile blood pressure

Detailed Answer:
Hello

Thanks for the query

I often see labile blood pressure in my patients but in order to call it labile I need more information from you

1. What are the highest and lowest recording of blood pressure. Please throw a light on the trend of blood pressure
2. do you snore at night ? was it evaluated earlier ?
3. do you smoke ? if yes then how much?
4. how much caffeine do you consume ?
5. are you compliant with your medicines?


Please get back to me , I am awaiting your reply

Regards

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Brief Answer:
Labile hypertension

Detailed Answer:
Hello

Thanks for getting back

Difficult to control hypertension is most often due to the following reasons

1. Increased salt intake. High salt intake commonly increases blood pressure due to water retention
2. Caffeine intake. Rise in blood pressure is seen in patients who consume large quantities of caffeine.
3. renal artery stenosis. These patients often have very high blood pressure requiring multiple anti hypertensives. Diurnal variation in blood pressure is known
4. Sleep apnea. Which I think is the cause of erratic blood pressure in your case

I don't think you hypertension because of adrenal tumour as these patients are usually very sick, they loose weight and also have cushingoid features.

Here is what you should do

1. Get a 24 hour XXXXXXX blood pressure monitoring ( it's different from holter monitoring). It measures blood pressure every 15 min through out the day, even at night
2. Loose weight
3. Get yourself a sleep study to know how much of sleep apnea is present
4. continue taking your medications and reduce salt intake. Avoid food items rich in salt

I hope I was of help, please get back to me for any further queries

Regards

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