Paroxysmal Hypertension, Labile Hypertension, Blood Pressure Attack, Pseudopheochromocytoma

People interested in this post may suffer from sharp blood pressure spiking, typically reaching greater than 180/100 and are aware of headaches and other symptoms. These BP spikes can be dangerous with potential to do organ damage. They can be so difficult to control that they lead to chronic disability.

Doctors generally assume such patients with labile hypertension may have pheochromocytoma, a rare cyst usually of the adrenal gland (only 700 cases in US per year). When that is ruled out by urine and blood sample, they tend to lump you in with all the other hypertensives of unknown causes.

The BP spikes can be triggered by emotional response, anesthesia, very banal stimuli like upright posture.or continuous discharge from the autonomic nervous system. Most antihypertensive meds are geared at elevated baseline BP and often over or under-control the condition. One diagnosis, that matches my symptoms, called Page's Syndrome, named after Irving Page, is provided below.

Page's Syndrome

Periodic blotchy flushing and perspiration in the face, upper chest and occasionally abdomen. The extremities are cold, pale and dusky. Headache, tachycardia and hyperperistalsis may occur. Blood pressure is labile and elevated during attacks. Low grade fever is occasionally present. It is believed to be due to vascular disease secondary to hypertension. Irvine Heinly Page (1901-1991), major American figure in hypertension research in the mid-twentieth century; born in Indianapolis, educated at Cornell, worked in Munich, Germany and New York, New York, then ultimately practiced in Cleveland, Ohio, discovered serotonin.

Page IH. A syndrome simulating diencephalic stimulation occurring in patients with essential hypertension. Am J Med Sci 1935; 190: 9-14.