Blood pressure flutuations during specific times - High & Low Blood Pressure Message Board

lamal3 · 10-06-2008, 11:07 PM

My blood pressure is fine when I wake up, and even during the afternoon but for some odd reason it rises from 8:25PM to 9:00PM. My readings are around 130-150 sometimes over 65-75. It's very strange. It would be normal most of the times but sometimes it does this. After 9:00pm my blood presure would come down once I fully relax. I take my ramipril around 9:15AM in the morning and 9:15PM at night. I used to take 160mg of diovan once a day but it wasn't as effective as ramipril so my doctor switched it to ramipril. My other medication includes inderal 160mg twice a day, norvasac 10mg once, apo furmosiide 20mg once, spirolatone 100mg once, asprin 325mg once. I'm only 27 years old and I have just had open heart surgery not too long ago. I just would like to know why during this time that it would trigger a sudden increase of bp? Is this a cause of concern? Once I take my medication from 9:15PM my bp is normal from then onwards.

lamal3 · 10-07-2008, 01:10 AM

anybody have any suggestions?

famnd · 10-07-2008, 11:44 AM

What are you doing at this time? Fam

flowergirl2day · 10-07-2008, 04:34 PM

lamal,

It's good to know you're recovering nicely from your surgery. I am sure your doctors are monitoring your progress closely. Make sure to mention any concerns, including your blood pressure spikes, during your next visit to the doctor's office.
I am on similar medication and have experienced similar issues with my blood pressure. I used to take my ramipril twice daily. My evening dose -10mg, taken around 9:30 p.m.- did nothing to lower my blood pressure, which remained elevated through the night. The nightly ACE inhibitor dose was not cutting it.

My doctor suggested taking all of my Norvasc (10mg) at night instead, and all of my ACE inhibitor -20mg-as one dose with my other medications in the morning. This simple switch in dosing times has worked well for me. My blood pressure is now on the low side in the evenings and at night.
I realize that your problem is a little bit different from mine - your blood pressure does not remain elevated for long. Be grateful for that. A variety of substances can raise blood pressure. Your brief blood pressure elevation could be due to drug interactions, suboptimal dosing or dosing times, reduced or enhanced response to antihypertensive drugs, or your body responding to a circadian rhythm or some other factor. I think it is most likely related to your medication. It would be interesting to draw a chart with the various half times of the meds in question. Perhaps the answer lies there, or in the changes in plasma concentration of the various drugs and their effect on cardiac output and hemodynamics. When do you take your second beta blocker dose? I took mine at bedtime for a while but suffered insomnia. Sometimes our bodies respond inapropriately to medication. Do you get an increase in heart rate, in addition to an increase in blood pressure?
I am aware of several interactions between the meds (I have almost the same meds). The aspirin reduces effectiveness of ACE inhibitors greatly. Any dose over 100mg is going to diminish the antihypertensive effect of ACE Is significantly.
Mention these spikes to your doctor and see what he says. He might suggest changing the times you take your medication - there is always room for an improvement. Sometimes the doctors switch people from short-acting medication to slow (extended) release medication - the dosing frequency can sometimes make a difference. It takes a while to find the types and dosages of medications that work best. Good luck. Let us know how it goes.

flowergirl

lamal3 · 10-08-2008, 01:47 AM

To answer your question famnd I'm either sitting on the couch watching tv or on the computer at home.