### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My aunt went to the emergency room last night around 9, she was hot and freezing and her side was hurting her.    Her blood pressure was 202 on the top when we first got there and then if came down to 192 and a little bit later it was 185 and then back to 192 - too high. what may be causing it

### output:

DEAR OVERTHINKS FOR CONSULTING AT ChatDoctorI UNDERSTAND YOUR CONCERN. BUT PROBABLY YOUR AUNT IS AN HYPERTENSIVE AND SHE IS NOT TAKING ANY MEDICATION ON THE DAY SHE WENT TO THE EMERGENCY A PRECIPITATING STRESS FACTOR MUST HAVE CAUSED A SHOOT UP OF BP THAT GRADUALLY DECREASED BUT STILL REMAINED HIGH AS SHE IS HYPERTENSIVESLIGHT FLUCTUATION CAN BE DUE TO AUTOMATED MACHINES, INTEROBSERVER VARIABILITY ETC .  YOU NEED NOT WORRY ABOUT THE FLUCTUATION BUT YOU NEED TO START YOUR AUNT WITH A ANTIHYPERTENSIVE AFTER CONSULTING A CARDIOLOGIST... I ALSO ADVISE YOU TO GET A ECG AND CARDIO CHECK UP DONE . To RULE OUT ANY UNDERLYING PATHOLOGY.HOPE I HAVE ANSWERED YOUR QUESTION. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS