My blood pressure readings vary throughout the day. Sometimes they’re high and sometimes they’re low. So I’m not sure if I have high blood pressure or not. Show Moshi Santa Monica Blood pressure varies throughout the day and is influenced by a number of factors, says Dr. Joshua Penn, a cardiologist with Cedars-Sinai Medical Group and in private practice in Beverly Hills. For starters, all humans have a natural daily rise and fall in blood pressure that corresponds with their circadian rhythm. For most people, blood pressure will be at its lowest in the early morning hours and then rise through the late morning and peak in midafternoon. Typically, this range will be about 10 to 15 millimeters of mercury on the upper, or systolic, value, which represents the peak pressure in the arteries; and five to 10 millimeters of mercury on the lower, or diastolic, value, which represents the lowest pressure at the resting phase of the cardiac cycle. Thus, a person with a resting blood pressure of 125/70 at 3 a.m., might have a reading of 140/80 by late afternoon. Other factors contribute to fluctuations in blood pressure, but the most common one is hypertension, a condition characterized by chronic high blood pressure. “When a person has a history of hypertension, or if the blood pressure has not been well-controlled over a period of years, then the vessels themselves become more reactive, meaning they tighten up with less provocation than they would in an average person,” Penn says. One of the manifestations of poorly controlled blood pressure is a high degree of variability, he says. A person with a lot of variation could easily have a blood pressure of 140/90 in the morning and a reading of 200/100 later in the day. Other factors, such as stress, emotional upsets and food sensitivities can cause an increase in blood pressure. Someone who is salt sensitive, for example, could get a double-digit boost from a big dose of salt. Certain street drugs, such as cocaine and methamphetamine, can cause a spike. Finally, there’s a phenomenon known as “white coat hypertension,” in which the stress of a visit to the doctor’s office causes an elevation in blood pressure. On the other side of the coin, alcohol, cessation of exercise and a warm environment can lower blood pressure. Penn has found home blood pressure devices (particularly the ones that measure blood pressure at the biceps, rather than the wrist or finger) to be reasonably accurate — “usually within 10 points on the upper and five on the lower. They can actually be quite helpful,” he says. Many physicians think that optimal blood pressure is below 120/80 and that blood pressure from 120/80 to 139/89 signifies that the patient may be at risk for hypertension. Blood pressure above 139/89 in several readings would be considered mild hypertension. “We know from data that lower natural blood pressure is associated with longevity,” Penn says. Hypertension, which is partly genetic and tends to increase with age, can usually be controlled with proper medical attention, diet and exercise. — Janet Cromley Wide fluctuations between doctor visits tied to raised odds of heart disease, early death, study says By Steven Reinberg HealthDay Reporter MONDAY, July 27, 2015 (HealthDay News) -- Wide blood pressure fluctuations may signal an increased risk of heart disease and early death, researchers say. The large study of people taking blood
pressure medication found that variations of more than 14 mm Hg in systolic blood pressure readings between doctor visits was linked to a 25 percent increased risk of heart failure. Systolic blood pressure is the top number in a blood pressure reading. "Patients should have their blood pressure controlled," said lead researcher Paul Muntner, a professor of epidemiology at the University of Alabama School of Public Health at Birmingham. "They should be aware that their blood pressure
changes, and if there is a lot of variation, they might want to talk with their doctor about why it's changing." These variations may be a sign of increasing damage to the arteries, particularly stiffening, Muntner said. About one in three U.S. adults has high blood pressure, according to the American Heart Association. For the study, published online July 27 in Annals of Internal Medicine, Muntner and colleagues analyzed data from a major trial
involving the use of medicines to fight high blood pressure and high cholesterol. The trial involved nearly 26,000 people. Blood pressure readings were taken at five, six or seven visits which were conducted between six to 28 months after the start of the study. Compared to patients whose blood pressure remained stable, the researchers
found that an average blood pressure variation of about 15 mm Hg was linked to a 30 percent raised risk of heart attack or fatal heart disease, and a 46 percent raised risk of stroke. In addition, the risk for death from any
cause was increased by 58 percent. Because these findings are based on an analysis of data from a large study, Muntner stressed they can only show an association between heart disease, death and blood pressure variations, not a direct cause-and-effect relationship. Some blood pressure medications, specifically calcium channel blockers and diuretics, are able to control blood pressure variations better than others, he said. But Muntner said patients should not seek to change their medications, since there is not yet firm proof that curbing swings in blood pressure will prevent these problems. High blood pressure is a leading contributor to heart attack, heart failure, stroke, kidney failure and premature death, added Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles. Lowering blood pressure to less than 140 mm Hg systolic and less than 90 mm Hg diastolic with medication and lifestyle changes is the long-standing treatment target, he said. Some other studies have suggested that visit-to-visit variations in blood pressure readings are also associated with increased risk of heart disease and stroke, he added. Further studies are needed to evaluate effective strategies for limiting visit-to-visit variability in blood pressure and the potential harms associated with it, Fonarow said. "People with high blood pressure should focus on consistently maintaining their blood pressure in the goal range by consistently taking their medications and adhering to heart- and blood pressure-healthy diet and exercise," he said. What is normal range of blood pressure fluctuation during the day?Normal blood pressure is considered 120/80mmHg or less in adults and children over the age of 13 years old. If your blood pressure fluctuates higher than this and stays there, you fall into the category of high blood pressure (hypertension).
Is it normal for blood pressure to fluctuate a lot?Blood pressure changes naturally many times a day. Most changes are normal and predictable. When these spikes and valleys in your blood pressure occur, you may not experience unusual signs or symptoms. These fluctuations may be brief and fleeting.
What time of day is bp most accurate?Blood pressure varies throughout the day. Readings are often a little higher in the morning. Also, your blood pressure might be slightly lower at home than in a medical office. Contact your health care provider if you have any unusual increases in your blood pressure or if your blood pressure stays higher than usual.
Why do my blood pressure readings vary so much within a few minutes?Everyone's blood pressure rises and falls many times during the course of a single day, sometimes even within minutes. Many factors contribute to these changes, including physical activity, emotion, body position, diet (especially salt and alcohol intake), and sleep deprivation.
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How much should blood pressure fluctuate during the day
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