BP Higher at Night?

[BiBi57]

I'm on high blood pressure medicine and have noticed that my blood pressure is at a normal reading in the morning and afternoon but in the evening it goes up to the "high" level" even after just taking atenelol. Does anyone else experience this? Anyone know the reason?

[Machaon]

Originally Posted by BiBi57

I'm on high blood pressure medicine and have noticed that my blood pressure is at a normal reading in the morning and afternoon but in the evening it goes up to the "high" level" even after just taking atenelol. Does anyone else experience this? Anyone know the reason?

I'll give you some terms to research. First of all, everyone has a circadian rhythm. That means that, certain times of each day, your endocrine system pumps out additional hormones. For instance, at night, "normally" the pineal gland pumps out additional melatonin, assisting humans and animals to sleep.

You have nocturnal hypertension, which means, of course, that your blood pressure is higher at night than it is during the day.

There are three main daily patterns for hypertension, diurnal (or dipper) hypertension, which is the most common, where the blood pressure is higher during the daytime, and dips during the night. There is also non-dipper hypertension, where the blood pressure is higher during the daytime, but does not dip during the night.

I have nocturnal hypertension. My blood pressure is lower during the morning, and then proceeds to climb during the day. At night, not only does my blood pressure go much higher, but my symptoms get worse then also.

Six years ago, in 1998, I was getting increased bouts of weakness, rapid heartbeat, fatigue, dizziness, hypertension and a tight chest. At the doctors office, in the morning, my blood pressure was fine, but at home it was much higher.

I started taking my blood pressure multiple times per day, in order to determine if my hypertension problems, and increased symptoms were frequent or infrequent. Basically, I wanted to know what was going on with my blood pressure.

I found out which meds were effective at controlling my symptoms, how long it took for each medicine to start working, and when each medicine started losing it's effect. Over time, I was able to significantly change the meds I was taking, and the dosages, and I have significantly lessened my blood pressure and associated symptoms. It has taken me a long time, and a lot of learning, and a lot of frustration.

At this point I have almost 14,000 reading, with all kinds of comments, by date and by hour. I produce charts and reports, which I take to my doctor.

Now..... back to you.

Nocturnal hypertension is mostly associated with either pre-diabetes, or diabetes. I don't have diabetes, but I have problems with high triglycerides, which is supposed to be a warning that diabetes could become a problem.

I can't eat anything with sugar, or carbohydrates after 6pm at night, or I'll suffer from increased symptoms all night long. Also, I've had to lower my daily consumption of carbohydrates and sugar. There are some meds that I can take during the morning, but if I take them at night, I react badly to them.

Just wanted to feedback, a little, of what I have learned about my own nocturnal hypertension.

Do you have similar problems? You are the first one that I have met, in years, that has nocturnal hypertension, so I wouldn't mind sharing notes.

Regards, and best of luck and health!

[BiBi57]

This is all very interesting to me and helps explain a lot. I have been on numerous HBP drugs but currently on Avalide (ARB with diuretic) 300 mgs. in morning and Atenolol 50mg 2X a day. I have been experimenting taking the atenolol - first dose at 5 p.m. and second dose at 10 p.m. to see if that makes a difference in nocturnal hypertension. It's also interesting that you mentioned the pre diabetes thoery. My dad has had high blood pressure all his life life (he is now 80 yrs.) and just recently got it under control through a good cardiologist. He has borderline diabetes and it runs in my family. At last exam my blood test did not indicate diabetes but that is definitely food for thought. I am tracking my numbers very carefully to get a pattern before I see a cardiologist this month. What has been your experience with different drugs? I have a high resting pulse so beta blockers work for me best but atenolol at 100 mgs! My doctor mentioned a betablocker that lacks the negative side effects. Do you know what one that is? He said is more expensive. It sounds like you have your situation under control and I want to control this frustrating disease while I am still relatively young (mid forties). Thanks so much for your insight!

[CASSIEBEL]

Beerzoids,
That is very interesting info. I also have normal Bp in the am then a gradual increase throught the day. Example: 116/69 @ 10:00am 151/81 @10:00pm. I also have high trigycerides and a weakness for sweets and carbs. I am on BenicarHCT 40/25, atenolol 75, and clonidine .05 as needed. I take the Benicar and 25mgs of the atenolol in the am and 50mgs of atenolol at bedtime with the clonidine if my systolic BP is over 150. I have been trying to solve this problem for 25 yrs with very little success.
I have always had normal blood sugar readings every year.
What do you think about my situation?
Cass

[Machaon]

Originally Posted by BiBi57

What has been your experience with different drugs?

I've tried Lasix (loop diuretic), Accupril (ace inhibitor), Extended release Nitro, Digoxin and Verapamil (Calcium Channel Blocker).

I've experimented for long periods of time with each med, by increasing or decreasing them for one or more weeks, and by gradually stopping them altogether and staying off of them for, from several weeks to several months.

I've found out that I need Digoxin to prevent tachycardia and slow my heart beat.

I need Verapamil to lower my blood pressure and control other arrhythmia problems.

The extended release nitro helps with my blood pressure but it causes uncomforable rhythm problems.

The Lasix lowers my blood pressure but gives me all kinds of rhythm problems and breathing problems.

The Ace inhibitor lowers my Systolic blood pressure, somewhat, no matter how much I take of it, and it works with few side effects. The only problem I have had with this med is additional heart rhythm problems if I consume too much potassium.

The only med that effectively controls my blood pressure is Verapamil, but only from certain manufacturers.

I've also tried beta blockers, had too many heart rhythm and breathing problems from them, so I stopped taking them. Since I was on other meds, at the time, I don't know whether it was the beta blocker, or an interaction with my other meds.

Another problem is, that things that one eats or drinks can also interact with a medicine. Drug manufacturers are not going to test their meds extensively enough, against food and drink interactions, since they don't want to chance not getting the drug approved.

I have a high resting pulse so beta blockers work for me best but atenolol at 100 mgs! My doctor mentioned a betablocker that lacks the negative side effects. Do you know what one that is?

There is not one drug known to mankind that doesn't come with side effects. Most doctors know very little about how any medicine will react with any patient, especially if the patient is on more than one med. Your doctor can't possible know how your environment, diet and lifestyle effects your meds.

I've been to many different doctors. With the seriousness of my heart disease, I've had to be very pro-active. I've said NO more times than YES to my doctors, regarding trying meds. I research them first before I would ever try another med.

Perhaps your doctor feels that if he tells you that you won't have side effects from the new med, that, somehow, psychologically you won't react normally to the med. When the doctors don't have a clue, which is a lot of the time, they try to play meaningless mind games on their patients.

Does the atenolol slow your heartbeat? How fast does your heart normally beat? What type of side effects do you get from the atenolol?

He said is more expensive.

That sounds like a pretty nasty side effect to me!

It sounds like you have your situation under control

I am doing the best that I can, but it is still a constant struggle.

and I want to control this frustrating disease while I am still relatively young (mid forties). Thanks so much for your insight!

Great idea. The older that I get, the more difficult it is to fight heart disease.

How high does your blood pressure get? When I don't have mine under control, my blood pressure will bounce around 170/105 during the day, and up to 185/120 at night.

Under control, my blood pressure averages around 140/89 during the day, and up to around 160/100 at night. I've got advanced heart disease. I feel much better at these lower numbers and I feel my chances for survival are much better. Others might look at my lowered numbers and go UGH!