Fluctuations in blood pressure with slightest exertion, what to do?

Nothing unless . . .: Blood pressure varies according to a number of variables including body position as well as rest vs exertion. To make diagnosis of hypertension (high BP) and adjust medications, we measure BP when sitting after resting a few minutes. So don't worry about fluctuations w/slight exertion unless you have other symptoms. Regardless, chat w/your family doc about your concerns.