Does blood pressure have a daily pattern? I've noticed that my blood pressure is always lower in the morning than at night.
Answer From Sheldon G. Sheps, M.D.
Blood pressure has a daily pattern. Blood pressure is normally lower at night while you're sleeping. Your blood pressure starts to rise a few hours before you wake up. Your blood pressure continues to rise during the day, usually peaking in the middle of the afternoon. Then in the late afternoon and evening, your blood pressure begins dropping again.
Having an abnormal blood pressure pattern, such as high blood pressure during the night or early in the morning, can mean that you have a health problem. Associated conditions include:
- Poorly controlled high blood pressure
- Obstructive sleep apnea
- Kidney disease
- Diabetes
- Thyroid problems
- Nervous system problems
- Cardiovascular disease
Risk factors for developing an abnormal blood pressure pattern include:
- Night-shift work
- Tobacco use
- Anxiety
- Too much stress
- Taking blood pressure medications that don't last 24 hours
Your doctor can tell you if an abnormal daily blood pressure pattern may need treatment. He or she may recommend a 24-hour blood pressure monitoring test. The device used for this test measures your blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over an average day and night.
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- Kaplan NM, et al. Kaplan's Clinical Hypertension. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2010:20.
- Turner JR, et al. Ambulatory blood pressure monitoring in clinical practice: A review. The American Journal of Medicine. 2015;128:14.
- Okutucu S, et al. Circadian blood pressure pattern and cardiac autonomic functions: Different aspects of same pathophysiology. The Anatolian Journal of Cardiology. 2011;11:168.
- de la Sierra A, et al. Nocturnal hypertension or nondipping: Which is better associated with the cardiovascular risk profile? American Journal of Hypertension. 2014;27:680.
- Birkenhager AM, et al. Causes and consequences of a non-dipping blood pressure profile. Netherlands Journal of Medicine. 2007;65:127.
Feb. 24, 2018Original article: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/FAQ-20058115