Why am I having episodes of severe hypertension?

[Jackjack91]

Background info; 24yr old male, no known medical issues, no substance abuse, non smoker.

Couple of months ago I’ve developed these symptoms where I start feeling dizzy, becoming sweaty, have palpitations, and my blood pressure goes from normally 115/70 to ridiculous amounts such as 210/110. I’ve had blood tests which checked my thyroid etc and showed no problems. I had a mild iron deficiency anemia which has resolved now and slightly low phosphate. I’m still having these symptoms. They’re coming on at any point, it can happen daily or I can be fine for days with nothing. I can’t find any trigger I can be busy working and bam or I can be chilling and watching tv. I feel the blood pressure is doing damage to my nerves now as since, I’ve started having tingling down my arm and fingers, trigeminal and occipital neuralgia symptoms. My doctor hasn’t given any solid diagnosis yet and I’m just fed up with feeling ill and not knowing.

I know I won’t get a diagnosis here but wondering if anyone has had similar experiences or know of what possible diagnoses it could be?

[Traveler07]

Hi, I've been experiencing severe blood pressure spikes myself - although I'm much older at 59 yrs. I have been researching this because 2 years ago, I landed in the hospital because, despite many medications and medication changes, my BP kept spiking throughout the day. I couldn't do anything other than wait for the next episode to happen.

What I've landed on is Baroreflex failure for me. It describes exactly what happened to me in the beginning (nearly 2 years ago now), and what keeps happening, although the more severe BP spikes are now controlled with hypertension meds (several) and clonidine as a rescue med.

There are quite a few other things to consider, but since no one has suggested you look into Baroreflex failure (it doesn't have to be total failure), I thought I'd mention it, because I started out just having BP spikes that quickly got out of control, and happened throughout the day.

I hope this information helps you either rule this out, or rule it in.

[abrogard]

don't know but I know if you google differential diagnosis you can perhaps find some material.  Here's an extract I've copied out from Churchill's differential diagnosis:

causes:
underlying cause found in less than 10% of essentialy hypertensive patients.

renal

renal parenchymal diseases e.g. glomerulonephritis
diabetic nephropathy
stenosis of renal artery
chronic pyelonephritis
polycystic kidney disease
connective tissue disease (esp. systemic sclerosis)

endocrine

cushing's syndrome
conn's syndrome
phaeochromocytoma
acromegaly

drugs

oestrogen-containing oral contraceptives
glucocorticoids - corticosteroids
monoamine oxidase inhibitors and tyramine
mineralocorticoids-liquorice
sympathomimetics-nebulised salbutamol
cardio vascular
coarctation of the aorta

other

pregnancy

[specialmom]

I don't know if you have thus far but obviously, you need a medical evaluation. You are checking your bp to know it gets up to 210/110?  You're awful young to have bp concerns but it can happen. Do you have panic attacks by any chance? Your adrenal system and your hormonal system can be responsible for things like what you describe. Is there any update?

[Jackjack91]

Thanks for your reply. I did question whether I have panic disorder or some PRSD. However, I’m a psychological therapist myself and when I review my symptoms alongside the criteria there is some overlap. Physical symptoms of anxiety normally present with a certain trigger. I’ve been unable to identify any consistent trigger which makes me reluctant to consider this. Also, I’ve had anxiety (worry) for my whole life but never physical symptoms really.

The follow up - I’ve been tested for lots, I’ve had my thyroid levels checked, metadrenalines, brain MRI (due to chronic migraine since the onset of blood pressure problems). I’ve been sent to a specialist cardiologist and awaiting results. At the moment they’ve only found minor abnormalities such as iron deficiency, borderline b12 deficiency, low phosphate levels, and heart has an RBBB.

Will keep this updated as and when I get somewhere :).