Dizziness and High Blood Pressure: When to Seek Help

Intermittent dizziness - elevated blood pressure?

Hello, doctor.
I have been experiencing some issues recently and I'm unsure which department to visit, so I would like to consult here first.
Let me explain what has been happening.
I noticed some pain at the lower edge of my heart a while ago, but it doesn't occur every day—maybe two days a week.
On those days, the pain is intermittent; sometimes it lasts just a few seconds and then goes away, while other times it can occur for a few hours.
Recently, the pain at the lower edge of my heart has subsided, but when I went to donate blood, I discovered that my blood pressure was quite high.
I also realized that I sometimes feel a bit dizzy, which seems to be related to the increase in blood pressure.
Whenever I feel dizzy, I check my blood pressure, and it usually ranges from 130 to 145 mmHg over 80 to 90 mmHg.
However, when I am feeling normal, my blood pressure seems to be around 120 to 130 mmHg over 75 to 85 mmHg.
I looked online and it seems to be outside the normal range.
I can't be sure how long this has been going on since I only started monitoring my blood pressure recently, so I only now realize that the occasional dizziness might be due to high blood pressure.

In the mornings, I generally feel normal and don’t experience dizziness, but sometimes by noon, I might feel dizzy again, which usually resolves itself, and then it might happen again in the afternoon or evening.
I also noticed that I sometimes feel dizzy when I enter crowded places, but it seems to improve when I am alone.
I’m not afraid of crowds as I am an outgoing person, but I have been noticing that the dizziness tends to occur in noisy environments or when I am around many people, and my blood pressure spikes again when I check it.
I often stay up late working, and the dizziness feels like a lack of sleep, and my neck is quite stiff.
I am worried that excessive fatigue might lead to some health issues, and I wonder if there could be problems with my heart, liver, or kidneys.
I would appreciate any guidance you can provide, and also which department I should visit.
Thank you.

Mr. Lin, 30~39 year old female. Ask Date: 2016/11/07

Dr. He Dongjin reply Cardiology

Hello, it seems you may be overworked.
A blood pressure reading of 130-145 mmHg systolic and 80-90 mmHg diastolic is not considered high blood pressure.
Recently, with the changing seasons and unstable weather, it is common to experience dizziness, which may not necessarily be related to blood pressure.
It is advisable to seek further evaluation at your primary care clinic.
Changhua Hospital cares about your well-being.

Reply Date: 2016/11/07

More Info

It sounds like you are experiencing a combination of symptoms that could be related to several underlying issues, including high blood pressure, potential anxiety, and possibly lifestyle factors such as sleep deprivation and stress. Let's break down your concerns and provide some guidance on when to seek medical help and what steps you can take.

Understanding Your Symptoms
1. Dizziness and High Blood Pressure: Dizziness can indeed be associated with fluctuations in blood pressure. Your readings of 130-145 mmHg systolic are on the higher end of normal, especially if you are experiencing symptoms like dizziness. It's important to monitor your blood pressure regularly, as persistent high readings can indicate hypertension, which can lead to more serious health issues if left untreated.

2. Heart Pain: The intermittent pain you described near the heart's edge could be related to several factors, including muscular strain, anxiety, or even gastrointestinal issues. However, given your history of high blood pressure and dizziness, it’s crucial to have this evaluated by a healthcare professional to rule out any cardiac issues.

3. Environmental Triggers: Your observation that dizziness occurs in crowded or noisy environments may suggest a possible anxiety response or sensory overload. This is not uncommon, especially if you are feeling stressed or fatigued.
4. Lifestyle Factors: You mentioned that you often work late and experience neck stiffness, which could contribute to your overall discomfort and feelings of dizziness. Poor sleep can exacerbate stress and anxiety, leading to a cycle of fatigue and increased blood pressure.

When to Seek Help
Given your symptoms, it would be wise to consult a healthcare professional. Here are some guidelines on when to seek help:
- Persistent Symptoms: If your dizziness persists or worsens, or if you experience any new symptoms such as chest pain, shortness of breath, or severe headaches, you should seek immediate medical attention.

- Blood Pressure Monitoring: If your blood pressure readings consistently exceed 130/80 mmHg, it would be advisable to consult a healthcare provider for further evaluation and management.

- Mental Health Considerations: If you find that anxiety or stress is impacting your daily life, consider speaking with a mental health professional. They can provide strategies to manage stress and anxiety, which may alleviate some of your physical symptoms.

Recommended Specialists
Based on your symptoms, you may want to consider the following specialists:
- Primary Care Physician: They can perform an initial evaluation, check your blood pressure, and assess your overall health. They may refer you to a cardiologist if they suspect any heart-related issues.

- Cardiologist: If there are concerns about your heart health, a cardiologist can conduct further testing, such as an EKG or echocardiogram, to evaluate your heart function and rule out any significant issues.

- Neurologist: If your dizziness persists and is not related to blood pressure, a neurologist can help determine if there are any neurological causes.

- Psychologist or Psychiatrist: If anxiety or stress is a significant factor, a mental health professional can provide support and coping strategies.

Lifestyle Modifications
In addition to seeking medical advice, consider making some lifestyle changes:
- Sleep Hygiene: Aim for 7-9 hours of quality sleep each night. Establish a regular sleep schedule and create a restful environment.

- Stress Management: Incorporate relaxation techniques such as deep breathing, meditation, or yoga into your routine.

- Regular Exercise: Engage in moderate physical activity, which can help lower blood pressure and improve overall well-being. However, consult your doctor before starting any new exercise program, especially if you have existing health concerns.

- Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit salt intake to help manage blood pressure.

Conclusion
Your symptoms warrant a thorough evaluation by a healthcare provider, particularly to assess your blood pressure and any potential cardiac issues. By addressing both the physical and psychological aspects of your health, you can work towards alleviating your symptoms and improving your overall well-being. Don't hesitate to reach out for help; your health is important.

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