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Blood pressure surges when emotional

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Hi there,

I wonder if anyone here ever has blood pressure surges when they cry or feel emotional, even just slightly.

I know it's usual for BP to go up a bit when we are stressed or otherwise upset, but mine jumps up drastically into very high numbers (180/100 or higher), then goes back to low.

My specialist has mentioned that this can be due to my autonomic issues (and largely, baroreflex failure issues), and how emotion can trigger an over-active response.

Just wondered if anyone else with Dysautonomia experienced this and if there's anything you do to remedy it?

I have medications like Diazapam (which is actually the first type of drug usually prescribed for baroreflex issues, to calm the sympathetic nervous system). I'm just worried about getting hooked on them, but at the same time, I can't cope with these surges any longer!

Many thanks for any feedback.


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Dear @Scout - I am so sorry you are having these surges! - I do not have baroreflex failure but I have HPOTS and NCS. When I was at my worst ANYTHING could trigger the high BP and tachycardia, even crying and often any type of stress. I do believe that being upset and crying falls under the emotional stress category, therefore a spike in BP may go along with the disease. If your physician has you only on Diazepam ( which should be taken as needed ) and the spikes appear despite it then you may not be adjusted properly. There are more meds you can take, as outlined in this article Four Faces of Baroreflex Failure | Circulation (ahajournals.org)

It lists Clonidine, Guanadrel, Guanethidine and Diazepam as commonly used treatments. However - as it is often the case it may be difficult to treat the Hypertension when it only occurs for brief, triggered episodes and stays normal or only slightly elevated in between. 

I understand your concern of taking Diazepam, since the threat of becoming addicted is real. I use Lorazepam for high stress situations to prevent flares and also use it at times for sleep, but I make sure that I only take it a few times a week and never more than one tablet a day. Hopefully you do not have a need to cry often 😟 so it may be safe to take it when you are upset, it may relieve the surge.

Wishing you more smiles 😉 - hang in there!

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@Pistol. Great article, thanks for posting. @Scout I too have serious BP spikes with anything that “stresses” my body. Concentrating on something, phone calls, emotional upsets, Dr appointments (even virtual) etc. etc. lead to very high BP but my HR goes down. I honestly don’t know how you tell if you have dysautonomia (I am diagnosed with hyper POTS) or baroreflex issues. Are baroreflex issues simply a form of dysautonomia or is it it’s own thing or is dys a baroreflex issue? I don’t have baroreflex failure because my body does respond to meds to control HR but my stress reaction is really exaggerated. I am on an alpha blocker and a beta blocker but alprazolam is what generally brings my BP down the fastest. It’s interesting that the article lists diazepam as a treatment for baroreflex issues. I had really bad rebound hypertension from clonidine and have not heard of the other suggested meds but will ask my new cardiologist about them next week. 

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