title: Severe paroxysmal hypertension induced by a subconscious Valsalva-like manoeuvres.
abstract: We describe the case history of a 32 year old male with severe paroxysmal hypertensive spikes when there was an increase in diastolic blood pressure to 150-200 mmHg. These spikes occurred during rest and especially during modest exercise. They were associated with headache and dyspnoea and were resistant to antihypertensive medication. After 5 years of observations and investigations he underwent further 24-h intra-arterial blood pressure monitoring and physiological testing. The 24-h blood pressure profile was near normal at rest. The observed hypertensive spikes seemed to be induced by involuntary Valsalva-like manoeuvres. This had not been detected previously by the investigators and the patient was unaware of inducing these manoeuvres.
authors.affiliation: Department of Medicine, Frederikssund Hospital, Denmark.
authors.forename: P E
authors.initials: PE
authors.lastname: Nielsen
authors.forename: F
authors.initials: F
authors.lastname: Jørgensen
authors.forename: J
authors.initials: J
authors.lastname: Conway
authors.forename: P
authors.initials: P
authors.lastname: Sleight
mesh_terms: D000328:Adult; D004417:Dyspnea; D015444:Exercise; D006261:Headache; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D012119:Respiration; D014636:Valsalva Maneuver