Wild swings in blood pressure

[lawgirl_x]

I am concerned about my blood pressure. I have had two 24 hour blood pressure monitors this year and both showed that I have wild swings in my BP.

Throughout the day, my BP swings back and forth from normal ranges up to 186/130 - without any reason. While I sleep, my blood pressure drops drastically, and stays around 80/42.

What could cause these symptoms? I also have significant respiratory muscle weakness (following a recent pulmonary test) - could this be connected?

Thanks in advance :)

[Jonathan D. Rich, MD]

Hello.

I frankly fail to see the relationship between the respiratory muscle weakness and either high or low blood pressure.  Having said this, people with certain neurological disorders can have wide fluctuations in blood pressure (sometime referred to as "autonomic dysfunction").  I am not saying that you have this but this is a better explanation that the resp muscle weakness one.  I am glad that your physicians are getting to the bottom of things and hopefully they will provide you with therapies that improve your condition.

All the best,

Dr. Rich

[lawgirl_x]

Thank you for your response Dr Rich.

My respiratory muscle weakness is 50% below what it should be and since my last message, my consultants have decided this is caused by a neuromuscular disease. They are putting their money on congenital myasthenia (I have had extreme weakness, ptosis, scoliosis etc since childhood, and diaphragmatic weakness responds well to typical CMS meds). I am currently awaiting genetic testing.

I am not breathing well during sleep and my respiratory consultant has ordered an urgent sleep study as she predicts I am waking up many times a night because of the decreased breathing.

If this were the case, and my diaphragmatic strength is even weaker when I am not awake, could it explain my very low blood pressure while sleeping?

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

What you are describing is not consistent with pulmonary hypertension (this is a PH forum).

I suggest that you see either a cardiologist or even an endocrinologist who specializes in hypertension for an evaluation.  There are many possibly causes for what you are describing and a thorough eval should likely help get to the bottom of things.  Frankly, however, I am not sure the respiratory weakness is directly related to this.  

All the best.

Dr. Rich