What does high blood pressure in the morning mean?

Many people have abnormally high blood pressure in the morning

Blood pressure fluctuates naturally throughout the day and tends to increase around the time a person wakes up. However, for many people, blood pressure may be abnormally high in the mornings. Doctors refer to this as morning hypertension.

Morning hypertension can increase the risk of heart attack and stroke. These medical emergencies often occurTrusted Source in the early hours when blood pressure rises. In this article, we explore the causes and effects of morning hypertension. We also look at ways in which people can prevent and control this condition.

Causes

Some potential causes of morning hypertension include those below.

Medication

Some people take antihypertensive medications to control their blood pressure. According to a 2018 reviewTrusted Source, uncontrolled morning hypertension may indicate a problem with the type or dosage of these medications. Specifically, morning hypertension may be due to one or more of the following factors:

taking a medication dosage that is too low
taking short-acting or intermediate-acting medications rather than long-acting medications
taking a single antihypertensive medication rather than a combination of medications

Some people may find that taking their medications before bed rather than in the morning provides better blood pressure control. Others may need to split their daily dose, taking half in the morning and half before bed. In some cases, a person may need to change to another type of blood pressure drug altogether. It is important to speak to a doctor before making any changes to medications.

Medical conditions

Certain medical conditions may increase the risk of hypertension. These include:

untreated high blood pressure
high cholesterol
cardiovascular disease
obstructive sleep apnea
diabetes
thyroid disorders
Cushing’s syndrome
lupus
scleroderma
kidney disease

Lifestyle factors

Certain lifestyle factors can also increase the risk of hypertension. Examples include:

smoking
heavy alcohol consumption
eating a diet high in salt and saturated fat
not getting enough exercise

Who is at risk?

The following factors can increase a person’s risk of developing morning hypertension:

being over the age of 65 years
being of African or Caribbean descent
having a relative with high blood pressure
having overweight or obesity
drinking alcohol
smoking
anxiety or excessive stress
insufficient sleep
disturbed sleep, for example, working night shifts

The function of blood pressure in the body

Circulation is similar to a highly sophisticated form of plumbing — blood has “flow,” and arteries are “pipes.” A basic law of physics gives rise to blood flow, and this law also applies in a garden hose pipe. Blood flows through the body because of a difference in pressure. Blood pressure is highest at the start of its journey from the heart — when it enters the aorta — and it is lowest at the end of its journey along progressively smaller branches of arteries. That pressure difference is what causes blood to flow. Arteries affect blood pressure in a similar way to the physical properties of a garden hose pipe affecting water pressure. Constricting the pipe increases pressure at the point of constriction. Without the elastic nature of the artery walls, for example, the pressure of the blood would fall away more quickly as it is pumped from the heart. While the heart creates the maximum pressure, the properties of the arteries are just as important to maintaining it and allowing blood to flow throughout the body. The condition of the arteries affects blood pressure and flow, and narrowing of the arteries can eventually block the supply altogether, leading to dangerous conditions including stroke and heart attack.