Dipping into high blood pressure – are you solving the problem ?

Click to listen to the audio…

Your asleep blood pressure is the blood pressure that matters

The time you want your blood pressure to be LOW, is not when you’ve visiting your doctor, you need it to be low, when you’re SLEEPING. What is your asleep BP ?

High blood pressure………………….. it’s a killer.

No doubt about this.

But, as with all things biological, it’s complicated, because…..

LIFE impacts blood pressure

Think about it…………….

there’s getting to work,
finding parking,
there’s work itself,
the kids,
your posture,
the weather,
the 6 cups of coffee you need to drink to get the job done and
your take away dinner

You get the picture, your blood pressure is going to move up and down, all day.

High blood pressure can be a good thing

In fact, high blood pressure is lauded as a health move, that’s why we’re all encouraged to go to the gym, where it’s good to have it up, momentarily. But if it is up, when you visit your doctor, well…………….then it is BAD.

And if it’s consistently up, in the doctor’s office………….. it get’s you a diagnosis of HYPERTENSION.

And more often than not, a drug prescription.

Because, as I said, high blood pressure is a KILLER.

It’s all about the timing

But, it is important to realize, high blood pressure is A KILLER, when it happens AT THE WRONG TIME. And this is the caveat…………

The time you want your blood pressure to be LOW, is not when you’ve visiting your doctor per se.

You need it to be low, when you’re SLEEPING.

In fact, this is what your blood pressure SHOULD LOOK LIKE over a 24 hour period.

There is a jolly big spike, when you get out of bed, and your blood pressure remains quite high for the first few hours of your day. Then it takes a dip, in the afternoon, reaching it’s lowest point in the day, in the late afternoon, before climbing for a second time, early in the evening. Once you’re tucked in bed, it should take a nose dive, dropping somewhere between 10 and 20 %.

You might or might not be following this pattern…………..

Dipping into health

When blood pressure is measured over a 24 hour period, this is referred to as ambulatory blood pressure monitoring, three patterns arise.

Here are samples of three different individuals….. let’s call them Dick, Tom and Harry.

Graphs showing abnormal blood pressure patterns across the day

Dick and Tom – will both have been diagnosed with high blood pressure.

Dick, REALLY has a problem.

Tom, NOT SO MUCH.

NOTE : He is likely taking blood pressure lowering meds, probably un-necessarily, they’re costing a fortune and putting him at risk of other health problems. Remember, drugs always have side effects.

What about Harry ?

Masked hypertension

Well, if his doc, didn’t do the ambulatory blood pressure monitoring, he would have been slapped on the back, with a jolly well done……… your blood pressure is NORMAL.

But, it’s NOT.

This guy is in T-R-O-U-B-L-E. Serious TROUBLE !

More and more scientific studies, show the risk from high blood pressure, is coming when blood pressure is high, when you’re “sleeping”.

You want to be a dipper

Unfortunately, to know whether you are or not, will require more than the blood pressure reading taken at home or in your doctor’s office. You need to be strapped up to a device, that can monitor your blood pressure over a 24 hour period and then report on your blood pressure, in the middle of the night.

The technology does exist.

And using it to diagnose high blood pressure, is actually recommended by most health authorities, but, it’s not always done………….

It’s expensive and inconvenient etc.

But, if you’re worried about cardiovascular disease, your asleep blood pressure, is the reading that REALLY matters.

And if this reading is high, this is the number you should be working to improve.

Asleep blood pressure is the target

So how do you do this ?

Well, it probably doesn’t take a rocket scientist to figure out, if you want your blood pressure to be low at night, you need to be doing what you can ,to keep your body’s clock in sync with the sun. Sleep, exposure to light and the timing of your meals, are just some of the leavers you can pull, to improve your circadian rhythm.

If you are taking blood pressure lowering meds, you want to take them, so they do their thing, AT NIGHT, because this is the time, you need them.

Optimizing the time, you take your medication, is called chronotherapy.

It’s something you should be doing………..

NOTE : Discuss this with your health care provider. Some meds, used to treat high blood pressure, like diuretics, these make you pee, do not lend themselves to being taken at night. But most do, and they do more for you, when you take them at night.

Hypertension: New perspective on its definition and clinical management by bedtime therapy substantially reduces cardiovascular disease risk. Eur J Clin Invest (2018) 48:e12909. Ramon C. Hermida, Diana E. Ayala, Jose R. Fernandez, Artemio Mojon, Michael H. Smolensky.