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Why is Blood Pressure Higher in the Morning?

Why is Blood Pressure Higher in the Morning?
Christine Kijek, RN, BSN, WON

Blood pressure varies throughout the day. It can be affected by the foods you eat, how active you are, and emotional stress. High blood pressure or hypertension is a leading cause of stroke, cardiac arrest, heart conditions, blood vessel problems, and aneurysm formation.

Of those being treated for hypertension, 50% still have morning high blood pressure. So why is blood pressure higher in the morning?

What is blood pressure?

When the heart pumps blood into the vessels, the pressure on the vessel walls is measured. The top number is known as systolic blood pressure. This measures the pressure that occurs when the heart is contracted. The bottom number is called diastolic blood pressure and measures the pressure in the blood vessels when the heart is at rest or relaxed.

Blood pressure can be elevated when the heart beats faster or if the blood vessels constrict or become narrowed. Those with the arterial disease may have higher blood pressure because of this narrowing.

What causes high blood pressure in the morning?

Our body has a 24-hour sleep/wake cycle called a circadian rhythm. During periods of sleep, the blood pressure is lowest. As we near the time to wake up, hormones such as adrenaline and noradrenaline are released by the adrenal glands. This causes a boost of energy, increasing blood pressure. The effects causing high blood pressure commonly occur between the hours of 6 am to noon.

Some are given medications to control blood pressure called antihypertensives. Morning hypertension can still occur while taking medication for these reasons:

  • Taking a medication that is low dose
  • Taking a short-acting mediation instead of long-acting
  • Taking a simple medication while needing a combination of medications

Risk factors for morning hypertension

Factors that increase morning hypertension are the same factors that cause all elevations in blood pressure. Modifiable lifestyle factors include:

  • Tobacco use
    • o Nicotine constricts the blood vessels
  • Alcohol use
  • Caffeine use
    • o Causes spikes in blood pressure
    • o A morning cup of coffee increases morning hypertension
  • Being aged 65 and over
  • Being overweight or obese
  • Work schedule
    • o Altered shift work confuses the circadian rhythm

Medical conditions that increase the risk for hypertension are:

  • Diabetes, type 1 and 2
  • High cholesterol
  • Sleep apnea
  • Adrenal tumors
    • Produce hormones that manage heart rate, blood pressure, and blood flow
    • Over-production of hormones increases elevation in blood pressure and heart rate
  • Certain medications can temporarily increase blood pressure. If taken in the morning, they can lead to morning hypertension.
  • Corticosteroids
    • Used to treat asthma
    • Autoimmune conditions
    • Allergies
    • Skin issues
  • Decongestants
    • Those containing pseudoephedrine

Avoiding and/or controlling morning hypertension

Lead a healthy lifestyle by:

  • Eating foods that help lower raised blood pressure
  • Avoid alcohol and tobacco
  • Minimizing caffeine intake
  • Taking blood pressure medication as ordered by your doctor
  • Monitoring blood pressure regularly, record and discuss findings with your doctor

Antihypertensive medications can be used in a variety of ways to control morning hypertension. Some may need to take medication at bedtime to control the morning spike in blood pressure. Others may need to take a lower dose twice a day, once in the morning and once at bedtime. If your blood pressure continues to be high in the morning hours, talk to your doctor before making changes to your medication regimen.

Blood pressure that is significantly elevated in the morning can be a sign that you are at a higher risk for cardiovascular disease. Monitoring morning blood pressure can help avoid or minimize the consequences along with maintaining a healthy lifestyle. Blood pressure control is vital for minimizing the risk of several cardiac conditions.


Author Profile: Christine Kijek, Registered Colorectal Nurse

Christine Kijek

Christine Kijek is a colorectal nurse at Danbury Hospital in Danbury, CT. She has a wealth of knowledge in this field as well as personal experience. HPFY is thrilled that she has been an active participant in the Ostomy Support Group. She has experience working as a coordinator for cancer patients, post-operative care, and home health care for disabled children and adults. And guess what! Christine is also the recipient of the Nurse Exemplar Award. Christine lives in Bethel, CT with her husband Ed. Her children are married and live nearby. She has 4 grandchildren and is known as GiGi. Christine enjoys riding motorcycles and spends many hours gardening. She can often be found onboard a Carnival Cruise ship lounging by the pool.



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HPFY Christine Kijek, RN, BSN, WON

Christine Kijek, RN, BSN, WON

LinkedIn Profile Christine Kijek is a registered nurse with a Bachelor of Science degree in Nursing. She has completed courses for wound and ostomy specialty and has 20 years of experience. She has ...

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