Blood Pressure Variations: Morning vs. Evening Readings

Q: Blood Pressure Variations: Morning vs. Evening Readings

Hello： If you experience a weight loss of 6 kilograms in a short period due to diarrhea, along with lower blood pressure than usual, and your blood pressure remains stable even after stopping antihypertensive medication, there may be concerns about inadequate fluid volume. <br>It

Significant differences in blood pressure between morning and evening?

Due to diarrhea, I lost 6 kilograms (currently 163 cm, 61 kg).
I suddenly stopped taking Concor (while on the medication, my blood pressure was 132/85).
After discontinuing, my morning blood pressure readings are a systolic of 125-135 and a diastolic of 82-92.
In the evening before bed, my blood pressure readings are a systolic of 99-115 and a diastolic of 69-75, with a gradual decrease in systolic pressure before bedtime.
What issues might I be experiencing?

SinHiap, 50~59 year old female. Ask Date: 2018/07/22

Dr. Lin Wuxuan reply Internal Medicine

Hello: If you experience a weight loss of 6 kilograms in a short period due to diarrhea, along with lower blood pressure than usual, and your blood pressure remains stable even after stopping antihypertensive medication, there may be concerns about inadequate fluid volume.
It is advisable to visit a medical facility to rule out the possibility of fluid volume depletion following diarrhea.
Based on subsequent changes in blood pressure, your physician will determine whether any adjustments to your antihypertensive medication are necessary.

Reply Date: 2018/07/22

More Info

Understanding blood pressure variations between morning and evening readings is crucial for managing hypertension and overall cardiovascular health. Blood pressure is not a static measurement; it fluctuates throughout the day due to various factors, including physical activity, stress, diet, and even the body's natural circadian rhythms.

In your case, the morning readings of 125-135 mmHg systolic and 82-92 mmHg diastolic are within a generally acceptable range, especially considering that you have recently stopped taking a medication (康肯, or KanKen). The evening readings of 99-115 mmHg systolic and 69-75 mmHg diastolic are notably lower, which is often a normal physiological response. Typically, blood pressure tends to be lower in the evening and during sleep due to decreased physical activity and relaxation of the body.

Several factors can contribute to the differences in blood pressure readings throughout the day:
1. Circadian Rhythm: Blood pressure naturally follows a circadian pattern, usually peaking in the morning shortly after waking and declining throughout the day, reaching its lowest point during sleep. This is partly due to hormonal fluctuations, such as cortisol levels, which are higher in the morning.

2. Physical Activity: Engaging in physical activity, especially in the morning, can temporarily elevate blood pressure. Conversely, relaxation and reduced activity in the evening can lead to lower readings.

3. Diet and Hydration: What you eat and drink can significantly impact blood pressure. High sodium intake can lead to elevated blood pressure, while adequate hydration can help maintain normal levels.

4. Stress and Emotional Factors: Stress and anxiety can cause temporary spikes in blood pressure. Monitoring your emotional state throughout the day can provide insights into your readings.

5. Medication Effects: Since you mentioned stopping KanKen, it's essential to consider how this might affect your blood pressure. If this medication was controlling your blood pressure effectively, its discontinuation could lead to fluctuations. It’s advisable to consult with your healthcare provider about the best approach to manage your blood pressure after stopping any medication.

Regarding your specific readings, the morning values are slightly elevated but not alarmingly so, especially if they are consistent with your previous readings while on medication. The evening values are quite low, which could indicate good blood pressure control at that time. However, if you are experiencing symptoms such as dizziness, fatigue, or any discomfort, it is essential to discuss these with your healthcare provider.

In summary, the variations you are observing are likely a combination of natural physiological changes and the recent cessation of your medication. It is crucial to monitor your blood pressure regularly and maintain a log of your readings to identify any patterns or concerns. If you notice persistent high readings or experience symptoms, please consult your healthcare provider for further evaluation and potential adjustments to your treatment plan. Regular follow-ups and possibly a reassessment of your medication regimen may be necessary to ensure optimal blood pressure control.

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