A:
Blood pressure normally goes up and down 20 or 30 points during the day. Surges up to 200/120 due to stress are out of the ordinary. Experts debate how much, if any, brief rises in blood pressure harm the body.
There has been a fair amount of research that studied whether a rise in blood pressure from psychological stress points to a higher risk of heart problems. I would take the available data like this: Maybe
but not much. Some studies suggest that every 10-point jump in blood pressure from stress carries a slightly higher risk of problems down the line. But most data suggest that this risk is small compared with your baseline blood pressure.
That said, when your blood pressure rises to this level, the arteries in your brain and other places are subjected to fairly high blood pressures, even if briefly. You might want to try breathing exercises or other stress management techniques to help lower your pressure.
Thomas H. Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance. 
