There is no doubt that tinnitus is complicated.
Ways to get tinnitus:
Damage to hair cells often from noise exposure or medications is one cause.
Another cause is from a systematic event that may be from injury or disease.
It does not matter what is cause for pre hypertension to develop.
With pre hypertension, any biological weaknesses can become more active or plain out develop.
Tinnitus can increase or spike from noise exposure and from things like ear wax, but a hyperactive moment - a sudden increase in blood pressure for a few minutes is often associated.
It's impossible to monitor blood pressure and vitals continuously unless being constantly monitored by a blood pressure unit and a CO2 clip on your finger.
On my profile page, I mention that that blood pressure and the thing that's placed on your finger are important tests.
For those with pulsatile tinnitus, a hyperactive event is a set off cause - 38% of the time. A partial hyperactive event 90% of the time. Hyperactive events associate to blood flow - brain, heart, abdominal, thyroid and veins and arteries. Life style - before such as smoking, bad foods and stress are often present with those that receive pulsatile tinnitus. One also usually has other health problems.
For those with physical tinnitus, all is the same as pulsatile tinnitus, except that physical injury, often connected to a physical weakness is present.
There is no doubt that stress, that causes hypertension contributes to tinnitus and spikes. Most concerning is a hyperactive event - getting a quick and sometimes just brief ( a few minutes ) of a blood pressure change with decreased oxygen levels.
Other things that can mess with a person's biology with or without conditions and disease is taking the wrong medications and/or vitamins for a condition, not getting the right ones, or taking the wrong combination.
Always place what you are taking at the same time into an internet search - any medications or vitamins. Such as magnesium and turmeric curcumin. Both have benefits if used with time spacing between doses. One can also place "can I take" A thru Z - with just using the names of what's being taken. Then always research your conditions to see if what you are taking is a plus or minus.
Magnesium or NAC, if tolerated and safe for use should be used one hour before going into an environment where there might be loud noise and one hour before going to sleep.
The brain is the Wizard of Oz where it come to tinnitus. When sleeping - if the brain is signaling to change sides, do it. This will help those with hyperacusis or a spike.