Clinical characteristics of patients with paroxysmal hypertension caused by panic attack

Objective To explore the clinical characteristics of patients with paroxysmal hypertension caused by panic attacks. Methods The clinical data of 24 patients with panic attack treated in Peking Union Medical College Hospital were retrospectively analyzed. Results Nineteen patients presented paroxysmal aggravation of hypertension. Blood pressure of the patients was usually controlled at (136±12/84±9)mmHg with antihypertensive therapy, and rose to (181±13)/(105±15)mmHg during panic attack. The other 5 patients were usually normotensive with average blood pressure (125±10)/(76±6)mmHg, and their blood pressure rose to (175±26)/(92±14)mmHg at panic attack. The surge of blood pressure last from more than ten seconds to six hours. And the attacks were irregular with the frequency ranging from once a few years to several times a day. The attack was triggered by psycho-emotional changes in 54% patients. The proportions of palpitation/panic, dizziness and chest tightness were 92%, 75% and 33% respectively. 24 hours urine catecholamines were normal in all patients. Conclusions Blood pressure of the patients may significantly enhance during panic attacks, mostly accompanying with palpitation/panic, dizziness, chest tightness. The attack may be triggered by psycho-emotional changes. Necessary biochemical tests are needed to exclude other diseases such as pheochromocytoma.