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Your blood pressure should be checked in the morning, about an hour after you wake up, and in the evening, about an hour before you go to sleep, using the same arm each time. Taking 3 consecutive measurements (about 1 minute apart) will provide a more accurate understanding of your "true" blood pressure.
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Read More »Patients with hypertension who specifically have morning hypertension have a higher risk of stroke, compared with other hypertensive patients without morning hypertension (Figure 2). Blood pressure increases when we first wake up due to the body's normal circadian rhythm. Circadian rhythm is a 24-hour cycle that affects our sleep/wake patterns. In the morning, the body releases hormones such as adrenaline and noradrenaline. These hormones give you boosts of energy but can also raise your blood pressure. The morning increase in blood pressure is usually seen between 6:00 AM and noon (Figure 1). If the blood pressure rises too high, it can cause harmful effects. Blood pressure is created when blood is pumped by the heart into our blood vessels. A normal home blood pressure reading should be less than 135/85 mm Hg. Systolic blood pressure (the top number) is the pressure created when the heart is contracted. Diastolic blood pressure (the bottom number) is the pressure created when the heart is relaxed. Blood pressure can be increased when our heart beats faster and harder or if our blood vessels tighten, making a narrower opening for the blood to flow through. Blood pressure varies throughout the day depending on foods eaten, physical activity, and emotional stress. Unfortunately, for some people, their blood pressure may be too high in the morning. This is called morning high blood pressure or morning hypertension. Researchers have found that morning hypertension increases the risk of heart and blood vessel problems such as stroke. Even in patients with well-controlled blood pressure, 50% still have high morning blood pressure. High blood pressure can cause a stroke, which is a sudden loss of brain function due to a lack of blood supply to the brain. Two types of stroke exist?ischemic or hemorrhagic. A stroke caused by a blood clot is called an ischemic stroke. Ischemic strokes are the most common, causing 85% of the 600,000 strokes that occur each year. Hemorrhagic strokes occur when a blood vessel ruptures in the brain. Morning hypertension also can increase your risk of other heart and blood vessel problems. It has been associated with changes in your heart's rhythm and size, which can lead to a heart attack or heart failure. Be sure to contact your doctor immediately if you experience symptoms such as severe headache, chest pain, and numbness or tingling in your face or arms.
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Read More »A healthy lifestyle that includes a nutritious diet, avoidance of tobacco and alcohol, and regular physical activity will help to protect you from morning hypertension. If you take blood pressure medications, take them as your doctor has ordered, and keep a log of your home blood pressure readings. These steps may help to prevent heart or blood vessel problems such as stroke. For more information on morning hypertension, visit www.morningbp.com/pt1. Dr. Gibson is a pharmacy practice resident at University of Colorado (UC) Hospital. Dr. Page is an associate professor of clinical pharmacy and physical medicine and a clinical specialist, Division of Cardiology, UC Health Sciences Center, Schools of Pharmacy and Medicine.
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