Sudden increase in BP - 200+

My wife, (age 78) had a mild hemorrhagic (brain bleed in basal ganglia) stroke last week. We got to the ER within 20 minutes of first symptoms (numbness/weakness on right side of body and loss of balance / confusion.

Her BP at the ER was 215 / 100. They gave her meds to lower it and put her in ICU, for a night, then a regular room for two days. Repeat cat scans showed the bleed had stopped. Her BP had come down to 155 and under when 150 when they discharged her. Only a slight weakness was detected in her right leg, but she has had arthritis on her knee and it may have been weak a long time. Other than initially, she never lost cognitive ability. She is not overly active and due to her weight (245) and arthritis, has slowed down doing gardening, etc in the last couple years. However she has kept up with household stuff, cleaning and meals.

There has never been a history of high BP. However, she's stubborn and hasn't gone for a regular check up in a year or so. She has previously never had any kind of symptoms of high BP (headaches, numbness). All kinds of tests indicated some ancillary side problems (borderline colesteral & borderline pre-diabetes .

It's been three days since discharge. She has no ongoing symptoms. A Physical therapist checked her out today and recommended exercises . The stroke and symptoms came on suddenly. There was no fall, no injury or any explanation. She was outside talking to a neighbor then walked into the kitchen, dropped stuff and could barely stand up or walk.

There is no question the high BP caused the bleed and stroke, yet no one can tell us the reason for the very quick rise in BP. Other than 10 year taking low (25 mg of) Doxipan for anxiety, sh is on no other meds other than small doses of Ibuprofin , Naproxin or Tylenol. Does anyone have any suggestions?

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