What Causes Fluctuations In BP Every Morning?

Posted on Mon, 7 Sep 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 7 Sep 2015 Answered on

Mon, 28 Sep 2015 Last reviewed on

Question : My father, age 90, has a big variation in blood pressure every morning. Starting about 205/95 upon rising from bed, 107/65 an hour later, then settling down for the day around 140/75 about three hours after rising. This has been going on for two months at least. He is taking lisinopril, atorvastatin, carvedilol, fish oil, glucosamine chondroitin, isosorbide mononitrate, probiotic dialy and rivaroxaban. His doctor is concerned about the stroke risk with hypertention, but seems to have no explaination about the daily variation.

Answered by Dr. Anantharamakrishnan (3 hours later)

Brief Answer:
investigation / rescheduling drugs - XXXXXXX help

Detailed Answer:
Hi friend
Welcome to Health Care Magic

It is difficult to say why this happens…
In the young, we generally investigate – hormones thyroid, cortisol, aldosterone and in particular epinephrine and norepinephrine… It is often cumbersome and may not be cost effective….
We routinely look at the basics like kidney function, electrolytes, especially potassium

In the meanwhile changing the timing / splitting the dose into 2 times and/or adding a small dose of diuretic (say the like of thiazide 6.25 or 12.5 mg) could help
The treating doctor alone could conclude better based on total clinical picture…

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar