Hello! Thank you for asking on HCM! I carefully passed through your question and would explain that these blood pressure fluctuations can be related to an adrenal gland dysfunction. I recommend some tests for this purpose (if you have not performed them yet): - cortisol and aldosterone plasma levels - urinary metanephrines for possible pheochromocytoma - thyroid hormone levels to exclude possible thyroid dysfunction. The vertigo can be explained with the peaks in blood pressure values. Anyway, a Doppler ultrasound of the cervical vessels would help exclude possible narrowing of the cervical arteries, which can also lead to vertigo. Hope you will find this answer helpful! Kind regards, Dr. Iliri