We often come across persons with noticeable high blood pressure recordings every day. These people show blood pressure variability (ranging from normal BP to high BP recordings.30 patients were followed up for a period of 12- 18 months. They were assessed for precipitating factors (stress, smoking, alcohol, sleep disturbances, headache and somatic pain).These factors were appropriately managed with medication and lifestyle behavior measures. 16.66% (5) of patients required to initiated on Anti-hypertensive in view of sustained hypertension.83.33 % study patients who showed normal to mild high BP (intermittently) recordings. So its essential to look for precipitating factors which influences the development of Sustained hypertension. Its rewarding to notice normalization of BP After initiating lifestyle and behavior modification (exercise, reducing excess salt, alcohol and smoking).so Transient high BP is a clinical entity with variable Blood pressure readings. This clinical state, requires follow up BP readings and identifications of precipitating factor, which may influence the development of Sustained/primary Hypertension.