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What Causes Violent Shaking While Having High Blood Pressure?

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Posted on Tue, 5 Jul 2016
Question: My husbands blood pressure is high 178. He's hands are shaking and hasn't been feeling well. Tired, no energy for the last 2 days. No fever. Takes 2 bp Meds. He took both this morning. One is really a water pill other is stronger. He took another 1/2 of the stronger pill after dinner. He did eat dinner and a 1/2 sandwich for lunch. Could the bp be causing the shaking hands? Hands seem not to be shaking as much now
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (9 minutes later)
Brief Answer:
About his bp and shakiness.

Detailed Answer:
Hello and welcome,

It's possible that the elevated blood pressure is causing shaking, but it may be the reverse: If there is some emotional or physical stress it may be causing both the shaking and elevated pressure.

Metoprolol, which he is using for blood pressure control, can help with shakiness sometimes. Please keep an eye on his blood pressure tonight and call his doctor tomorrow morning to report what is going on.

If his upper number is 180 or higher, or his lower number is over 109, then he should go to the ER where it can be lowered carefully in a controlled setting while he is monitored.

I hope this information helps. Please let me know if I can provide further information or clarification.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (13 minutes later)
When he first took his bp it was 180 but took again 1/2 hr later and it went to 178. Waiting for him to take again to see if it's gone done but he's resting now. Shaking is better but I'm very concerned. He not really under stress that I know of and I asked him if something bothered him at work today which he said no. He went to work, came home and rested and went back. Shaking didn't happen til before dinner. Maybe hunger and high bp caused the issue? The shaking has happened before a few months ago and lasted a day or two.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 minute later)
Brief Answer:
About his blood pressure.

Detailed Answer:
Do you know if his blood pressure was elevated that last time he had the shaking?

And how severe is the shaking? A mild tremor or course hand flapping type movements?

Is the metoprolol and extended release formulation? You would know by the bottle saying XL or ER. Because if it is, the medicine may take awhile to bring down his pressure.

I too am concerned about a pressure of 180 even if it came down to 178. How long after the medication was this?

Can you retake his blood pressure while he is resting?


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (12 minutes later)
Mild shaking which seems to have gotten better. Bp is now 166/106/86. Took extra Meds an hour ago. I don't know if his bp was high last time the shaking happened as we were out of town and he didn't bring his monitor. Metoprolol is ER.

I forgot to answer the 180-178 question. That was before he took any extra Meds. He just waited 1/2 hr to see what it was.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
SBP of 166 isn't good but it's safer.

Detailed Answer:
His blood pressure is getting into a safer range now. The metoprolol ER should continue to help. Still need to follow up with his doctor tomorrow.

Something to consider is that hyperthyroidism can cause shaking hands while other symptoms of excessive thyroxine may be masked by a beta blocker medication such as Metoprolol. So it might be a good idea to get a TSH (thyroid stimulating hormone) level and thyroxine level just to make sure things are ok in that department.

It is also possible the shaking was from hypoglycemia as you suggested.

I think I mentioned before that beta blockers like metoprolol can treat shaking hands regardless of it's effect on blood pressure.

But still tell his doctor about the hand tremor too so he can do a neurological exam.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (19 minutes later)
Thank you for all your help so far tonight. What does excessive thyroxine do? I'm going to have to "pull out all the stops" to get him to call his doctor tomorrow. Very stubborn guy and thinks he's ok even when he's not. It's not good that he's hasn't been feeling well and I have a feeling it's due to his high bp which I know can cause tiredness along with other things. He's going back to checking his bp daily even if he dies the want too. I'm also concerned about the thyroxine so if you could explain that it would be helpful.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (9 minutes later)
Brief Answer:
About hyperthyroidism

Detailed Answer:
Hi XXXXXXX

Sometimes the thyroid, for various reasons, can produce too much or too little thyroxine. Some of the causes can be from a virus (which is usually self limited) and from autoimmune problems.

One of the most noticeable symptoms of excess thyroid production (hyperthyroidism) is a rapid heart rate and palpitations. However if a person is on a beta blocker like metoprolol, that will not happen as that type of medicine controls heart rate.

Other symptoms include weight loss, nervousness, intolerance to heat (and sometimes to cold), fatigue, and sometimes insomnia.

Thyroid disorders are usually treatable or controllable. And that might not be what is going on at all with him. It's just something that is good to check.



Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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What Causes Violent Shaking While Having High Blood Pressure?

Brief Answer: About his bp and shakiness. Detailed Answer: Hello and welcome, It's possible that the elevated blood pressure is causing shaking, but it may be the reverse: If there is some emotional or physical stress it may be causing both the shaking and elevated pressure. Metoprolol, which he is using for blood pressure control, can help with shakiness sometimes. Please keep an eye on his blood pressure tonight and call his doctor tomorrow morning to report what is going on. If his upper number is 180 or higher, or his lower number is over 109, then he should go to the ER where it can be lowered carefully in a controlled setting while he is monitored. I hope this information helps. Please let me know if I can provide further information or clarification.