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High Blood Pressure




Dear Sir,

Thank you for your last answer on white coat hypertension. I`m still sick and I`ve changed doctor for a second advice. We are waiting for tests as I might have pheochromocytoma. Those tests have never been done before. All what happened to me that I described in my question on "high blood pressure and low pulse" really look like the symptoms of pheochromocytoma but only the urine tests will give us the answer.

Do I need to have very high blood pressure (over 20/10) or HBP (14/9 to 16/11) when I have crisis is sufficient to be a possible pheochromocytoma. I do have other symptoms as fast beating heart, blurred vision, headaches, weakness.


Although episodes of severe hypertension are often considered typical of pheochromocytoma, in many cases the hypertension is fairly mild but sustained.

Pheochromocytoma is rare, but it should to be considered in every case of hypertension that does not respond well to medication or that is accompanied by symptoms like sweating, palpitations or flushing.

The best test for pheochromocytoma is a 24 h urine collection for metanephrines and catecholamines.  It is important to remember that several medications can interfere with the accuracy of the test.  The most important ones are acetaminophen, labetalol and clonidine.  Also, any form of major stress can increase urinary catecholamines and give a false positive result.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati