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High Blood Pressure

Re: High blood pressure during sleep

08/20/2007

Question:

I am a 52 year old female with normal daily blood pressure of 110/60 or less. I take 25mg Atenolol 2 times a day to slow a rapid heartbeat. I have noticed that my blood pressure rises to betweeen 124/70 to a high of 158/93 at night when I sleep. I have recorded the 158/93 at 2am and 137/80 at 2am on two consecutive nights. It is strange. If I sleep in my lounge chair at night the BP rise is only 124/70 but in the bed it goes higher(158/93). Should I be concerned with these nightly BP rises. My daily BP is very normal to low of 104/50. Or is this nightly rise normal and not dangerous since daliy BP is low.

Answer:

If you check your blood pressure in the middle of the night, the result may not be representative of what your usual blood pressure is.  The best way to check your blood pressure during the night is by 24 hour ambulatory monitoring.

Atenolol is a short acting medication and may not be ideal.  You should consider switching to diltiazem CD or to Toprol XL.  Diltiazem CD is a long acting calcium channel blocker and Toprol XL is a long acting beta blocker.  Both of these are likely to control you heart rate better throughout the night. You should discuss your medication with your doctor.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati