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High Blood Pressure

Re: Can BP go in and out of control



I am currently taking Toprol 100mg at 8am daily and cozaar 100 at 7pm daily for hypertension. My BP seems to go in and out of control. One day it is below 120/80 most of the. Some days it is greater than 140/80 plus in the afternoon and goes to 150/85 plus in the early am. Then it may go back to the below 120/80 for most of the day and rise to 130/80 plus in the early am. However it can be less that 120/80 in the early am. This fluctation is madding and hard to describe to the doctor. I this fluctiation on medication normal. I have compared my automatic BP monitor to the manual type and it is more or less accurate. I need help on how to proceed with this problem. Do I need medication increase or do I need to change the times I take the meds or change meds. Help


It is normal for the blood pressure to vary during the day.  The goal of therapy is to keep the average blood pressure below 140/90 during the day, and below 125/75 at night.  In people at higher risk, the goal is lower, below 130/80 during daytime.

In your case, you can consider adding a low dose of a diuretic (e.g. hydrochlorothiazide, 12.5 mg per day) to your regimen.  This addition is unlikely to cause any side effects, and can lower your blood pressure by another 10 points. You should discuss this with your physician.

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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