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What causes sudden spike in blood pressure?

Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. Normal blood pressure levels are considered lower than 120/80 mmHg, while high blood pressure is a pressure of 130/80 mmHg or higher. Sudden spikes in blood pressure, also called acute hypertension, can occur when blood pressure rises quickly and severely over just a few minutes to hours.

What is considered a sudden spike in blood pressure?

Doctors consider a sudden spike in blood pressure to be an increase of 30 mmHg or more for systolic blood pressure or 15 mmHg or more for diastolic pressure over a short period of time. For example, if your blood pressure is normally 120/80 mmHg, an acute spike would be a sudden rise to 150/95 mmHg or higher.

Acute hypertension requires prompt medical attention to help bring your blood pressure back down and prevent complications. Extremely high blood pressure, such as 180/120 mmHg or greater, is considered a hypertensive crisis and requires emergency treatment.

What causes sudden spikes in blood pressure?

There are a variety of potential causes of sudden, acute spikes in blood pressure. Understanding what’s behind your rise in blood pressure can help you and your doctor better manage it.


Stress causes the body to produce more cortisol and adrenaline, which can lead to vasoconstriction (narrowing of the blood vessels) and fluid retention. This stresses the cardiovascular system and increases blood pressure.


Like stress, anxiety activates the sympathetic nervous system, which controls the fight or flight response. This leads to surges in hormones that induce vasoconstriction, spiking your blood pressure.


The hormones released in response to pain can cause blood vessels to narrow and heart rate to increase. Acute pain from conditions like kidney stones or a heart attack can cause severe, sudden spikes in blood pressure.


Certain prescription and over-the-counter medications can cause acute spikes in blood pressure, including:

  • Decongestants
  • NSAIDs
  • Steroids
  • Birth control pills
  • Some antidepressants
  • ADHD medications
  • Immunosuppressants
  • Cough and cold medicines

Alcohol and recreational drugs

Consuming too much alcohol at once causes blood pressure to rise. Illicit drugs like cocaine and amphetamines also severely spike blood pressure.


High doses of caffeine from coffee, energy drinks, or supplements can overstimulate the heart and blood vessels, increasing blood pressure.

Sleep apnea

Obstructive sleep apnea causes reduced oxygen levels and disrupted sleep, which spikes sympathetic nervous activity during the night, raising blood pressure.


This type of adrenal gland tumor causes massive releases of adrenaline, inducing sudden blood pressure surges throughout the day.

Thyroid problems

Both overactive thyroid (hyperthyroidism) and underactive thyroid (hypothyroidism) can trigger high blood pressure spikes due to imbalances in metabolism and hormones.

Pregnancy complications

Conditions like preeclampsia and eclampsia can cause severe spikes in blood pressure in pregnant women.

Quitting smoking

Smoking increases the levels of chemicals that constrict blood vessels. When someone stops smoking, these chemicals are reduced rapidly, causing rebound vasoconstriction and spikes in blood pressure.

Risk factors

Certain factors can increase your risk of sudden blood pressure spikes, including:

  • Older age (65+)
  • Being male
  • Family history of hypertension
  • Being African American
  • Obesity
  • Sedentary lifestyle
  • High sodium diet
  • Excess alcohol intake
  • Smoking
  • High stress
  • Sleep apnea
  • Kidney disease
  • Adrenal disease


Signs and symptoms of an acute spike in blood pressure can include:

  • Severe headache
  • Shortness of breath
  • Nosebleeds
  • Flushed face
  • Rapid heartbeat
  • Dizziness
  • Confusion
  • Vision changes
  • Chest pain
  • Nausea


To diagnose a spike in blood pressure, a doctor will:

  • Take your blood pressure readings
  • Ask about your symptoms
  • Review your medical history
  • Look for underlying health conditions
  • Order blood tests and urinalysis
  • Perform an EKG
  • Do imaging tests like a CT scan or ultrasound

Emergency treatment

For severe spikes in blood pressure, especially with readings over 180/120 mmHg, emergency medical treatment is needed to prevent complications like stroke, heart attack, or kidney damage.

Emergency treatments may include:

  • IV blood pressure medications like nitroprusside, nicardipine, or labetalol
  • Oxygen therapy
  • Pain relievers for symptoms like headache
  • Sedatives for agitation or anxiety
  • Diuretics or dialysis for fluid overload

The goal is to safely reduce blood pressure within the first hour to under 160/110 mmHg, then continue lowering it to normal levels over the next 2-6 hours.

Home remedies for minor spikes

For mild to moderate spikes in blood pressure under 180/120 mmHg, you may be able to use home remedies alongside medication to help lower your levels.

Deep breathing

Taking slow, deep breaths stimulates the parasympathetic nervous system to promote relaxation and vasodilation.

Cold compress

Applying a cold cloth to your forehead, neck, or wrists constricts blood vessels and lowers pressure.


Quieting the mind through practices like mindfulness can activate relaxation responses.


Light aerobic activity stimulates nitric oxide to dilate blood vessels.

Stay hydrated

Drinking water prevents dehydration, a common trigger for blood pressure spikes.

Reduce sodium

Avoiding high-sodium foods minimizes fluid retention.


You may be able to reduce episodes of sudden blood pressure spikes by:

  • Managing stress
  • Getting enough sleep
  • Exercising regularly
  • Eating a healthy diet
  • Losing weight if overweight
  • Quitting smoking
  • Limiting alcohol and caffeine
  • Taking medications as prescribed
  • Monitoring blood pressure at home
  • Seeing your doctor regularly

When to see a doctor

Consult your doctor right away if you experience:

  • A spike in blood pressure over 180/120 mmHg
  • Hypertension with signs of organ damage like chest pain
  • Symptoms like difficulty breathing, change in vision, or confusion
  • High blood pressure that doesn’t improve with home remedies

Sudden spikes require prompt evaluation and treatment to prevent complications. Work with your doctor to determine the cause and keep your blood pressure under control.


Acute spikes in blood pressure over a short time frame are dangerous and need immediate medical care. A variety of factors like stress, medications, and health conditions can trigger surges in blood pressure. Seek emergency treatment for severely high readings over 180/120 mmHg. For smaller spikes, home remedies combined with medications may help stabilize your blood pressure.