Itsmylife2

[itsmylife2]

I've just been told I have very high blood pressure . After trying Amlodipine which didn't suit I am now on Ramipril. Please can anyone tell me why my blood pressure reading is much higher in the evening. I am 83 and have no-one to ask. Thank you.

[Borderterriorist]

I did a quick google and apparently about 15% of the population are "reverse dippers" Ie their BP rises at night rather than in the morning. I've added a link that you may like to read.

ox.ac.uk/news/2022-09-23-ni...

[Happyrosie]

along with what’s been said, you might find the website of Blood Pressure UK, the specialist charity, helpful.

[itsmylife2 in reply to Happyrosie]

Thank you for advise.

[fishonabike]

It is normal for BP to be higher on waking and lower in the evening but in people with high blood pressure the BP may not drop in the evening

if you take medication to control your BP in the morning the effect may not last all day, so you can get an increase in BP at the end of the day - you may need to report this to your prescribing doctor and discuss whether you need controled release medication so that your BP is controlled for 24hrs

[itsmylife2 in reply to fishonabike]

Thank you. I'm new to this and it all seems bewildering.

[devonian186]

What's your definition of "Very high" as the parameters change as we get older.

Also, how do you take the BP readings? If you have been "told," is that via a GP or more likely a practice nurse?

The typical way of doing this is to rush you in from reception, sit you down, slap a cuff on straight away, then take 2 readings. The results are likely to be inaccurate, not helped if you have white coat syndrome.

To check the readings you need your own BP machine which can be purchased inexpensively from larger Chemists. Then you need to follow the instructions, and in the morning before breakfast (and before taking caffeine) place the cuff correctly and in a tranquil atmosphere, take at least 2 readings a minute apart and again in the evenings, well before a meal..

You need a weeks worth of readings to establish a pattern which are likely to be different to that taken at the surgery.

[itsmylife2 in reply to devonian186]

Thank you. I have a monitor.

[Taviterry]

Excellent advice already, so all I'll add is that my BP is a little higher in the evenings than on awakening and before taking Ramipril. After an alarming spike in my BP a month ago, I'm keeping a spreadsheet of readings, with notes on how I spent the preceding hours - sedentary, light exercise, or sustained exercise such as a walk (that briefly substantially lowers my BP).

You haven't said anything about any other medical conditions, including those affecting the heart. I have an artificial heart valve and understand that a slightly elevated systolic reading is better than a normal one, as long as my diastolic one doesn't go above 90. Not that the surgeon who told me this cited any "ideal" systolic figures!

[itsmylife2 in reply to Taviterry]

Thank you. Luckily I haven't any other issues and your reply is reassuring.

[Furbaby9]

What’s your Bp numbers?

[Babsiom]

I am in the same boat. My blood pressure is still high but I’ve been given Sertraline 5mg too. I was 4 days in hospital on amlodipine and it wouldn’t go down. The doctor started me with 2.5 dose but because they wanted the bed, sent me home with 5mg dose. Now I’m dizzy, feeling sick and weak and breathless going up the stairs. It was a panic attack that sent my heart rate to over 200. Sometimes I wonder will it ever get better. Hope you get sorted, how many of us are there with this anxiety?

[Jaybbb in reply to Babsiom]

I was put on amlodipine the day the stent was placed. Originally the cardiolgist prescribed 10 mg, but I indicated we should start with 5 mg, and we did. My BP went from over 140 to a constant between 110 and 120 on Amlodipine. And sometimes lower. Different people have different reactions.

[itsmylife2 in reply to Jaybbb]

Thank you for replying.

[Goonerboy6661]

Hi there, I just wanted to reach out and hopefully offer you a bit of reassurance. It’s actually very common for blood pressure to fluctuate throughout the day, and many people notice that their readings can be higher in the evening.

There there could be a few reasons for this:

• Natural Circadian Rhythm: Blood pressure tends to rise and fall in a daily pattern. It’s often lower overnight and first thing in the morning, gradually increasing during the day and sometimes peaking in the late afternoon or evening.

• Daily Stress & Fatigue: As the day goes on, physical and mental fatigue, as well as any stress you’ve experienced, can all contribute to higher readings.

• Medication Timing: Depending on when you take your blood pressure medication, the effect may start to wear off later in the day.

• Food, Hydration, and Activity: Meals, salt intake, dehydration, or being more active during the day can also influence evening readings.

You mentioned you’re now on Ramipril — it can take a little time for your body to adjust and for your readings to settle, so don’t be too discouraged by short-term fluctuations.

Finally, if your evening readings are consistently high or causing you concern, it’s always worth discussing with your GP. They may adjust the timing or dose of your medication or suggest monitoring for a bit longer.

You’re definitely not alone in this — many of us on here have noticed similar patterns, and it’s something your healthcare team can help you manage.

Wishing you well

[itsmylife2 in reply to Goonerboy6661]

Thank you so much, this is very reassuring.

[SuddenShock]

I have said it a few times before in this forum but a lot of our anxieties come from not being given information that we understand.

Not meaning to be rude to those trying to help us but I do have the impression that sometimes the person giving the information does not understand or cannot explain it and might rely on the use of shocking phrases to convince us to not ask too much!

[itsmylife2 in reply to SuddenShock]

This is true. Sometimes an overload of information is too confusing to process property.

[OK10]

I am taking 5mg Felodopine in the morning and 5mg Ramipril at night. This covers me for 24 hours and my bp is ok now. I suggest you talk to your gp.

[itsmylife2 in reply to OK10]

Thank you, I will