Suggest treatment for dizziness and high BP
Patient: Hi I am a 33 year old with dizziness, ha s and HTN over the last week. A am a RN and took my BP with a automatic cuff 174/106 after expereriencing dizziness and HA and episode of nausea. I immediately called clinic and was seen but BP had gone down to 136/102. They did an EKG, UA a/HCG and labs-all of which were normal. I am healthy, 33 y/o, work out 4-5 days a week, 5 9, 147 lbs and only take BCP s. My mom has HTN but is also overweight. I am not stressed. They thought I had BBBV or a migraine. But my HA was not that bad (it was no migraine). Why would my BP be elevated with BPPV? I saw a PA who did not seem to think it was a biggie having my BP that high. My BP s since then have gone done to 140 s/upper 90 s. I know in the past my BP is usually high when I get seen because I am really sick or in pain. For all I know I could have been having elevated BP for some time now......any ideas. Dizziness is still there a little (not as bad) was able to work out, slight HA, BP 145/98. Thanks concerned RN Doctor: Hello,  As what I understand from the history is that the dizziness and nausea feeling is due to vertigo. As both are inter related and are due HMF. The nausea feeling can be triggered by Chemoreceptor trigger zone due to vertigo.  Since you mentioned you Blood pressure was high on a digital monitor at home, was it same way measured digitally at the physician centre? If not than did you follow the correct way of measuring the blood pressure? like taking rest in lying position for 30 minutes before taking the blood pressure? also was this measurement of blood pressure happened in sitting position as soon as you reached the physician centre? which arm was showing signs of high blood Pressure the right or the left?  Many things are unanswered in the history. but as you mentioned about your age as in the early 30s and you are a good physical workout kind of person , ignore this high blood pressure every now and then as it may be fluctuating in the time of the day.   If we have to confirm you are having a high blood pressure than we need to follow the basic principle and also have to check you on a sphygmomanometer along with Echocardiogram and Electrocardiogram with some blood routine. Also, there should be some clinical symptoms before confirming you are having hypertension.  As what I feel is your blood Pressure is not the concern and the concern is the BPPV. You need to meet up a good neuro physiotherapist so an exercise prescription is provided which should help you.  In my clinical practice of 12 years I have been coming across such cases of vertigo and that is dealt with proper assessment and examination. Most have been having on their early 30s lowered the blood Pressure and also the symptoms of vertigo with a precise exercise prescription and vertigo medication.  I wish you good luck and request you to stay calm and follow the guidelines of exercise. You should do well.  Hope I have answered your query. Let me know if I can assist you further.  Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist