Blood pressure variability and hemodynamic response to stress in patients with paroxysmal elevation of blood pressure.

Blood pressure variability during 24 hours and hemodynamic response to stress were studied in essential hypertensive patients, displaying paroxysmal hypertension and pheochromocytoma-type symptoms (PH). Hemodynamics at rest, in response to mental arithmetic, bicycle ergometer exercise or the cold together with baroreflex sensitivity were not different between these patients and other essential hypertensives (EH). Average waking systolic blood pressure was lower but variabilities of both systolic and diastolic blood pressure were greater in PH than in EH. During sleep, these differences disappeared. Thus, the greater variability in blood pressure seen only in waking PH patients cannot be estimated from the hemodynamic patterns at rest and is not likely to be related to an excessive response to stress or impaired baroreflex.