What could be the reason for high BP in the evening?

Question

Hello doctor,

My age is 43. My weight is 167 pounds, and my height is 5.5 feet. I was an athlete and discontinued sports around ten years back. I am an ecology and environment consultant by profession.

I was diagnosed with hypertension six years back and was taking medicine last year. My BP reached the highest level of 140/100 mmHg. Thrice I had a complete cardio checkup and was normal all the time. My cholesterol levels were high. Initially, I was taking Olmezest 10 mg and Rozat 10 mg; later, I switched to Olmezest 40 mg and Rozat 10 mg.

Last year, when my BP was normal within 120/85 mmHg, the doctor asked to stop the medicine for a month. As my BP was normal within 120/85 mmHg, I stopped taking medicine for almost one and a half years. But, for the last three days, I have had mild discomfort.

When I checked, my BP was 140/100 mmHg. My BP was high in the evening hours and otherwise, it was 10 points less both in diastolic and systolic. I have not visited any doctor or taken any tests yet. Should I continue the medicine or change it? What could be the reason for a rise in BP? What test should I perform? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

The basic question is if you really have hypertension or all along was it just what we call white coat hypertension, which shows high blood pressure readings in the hospital alone? To answer this we have two options.

First, you can do a home BP recording with a reliable BP apparatus. Home systolic BP values greater than or equal to 135 mmHg or diastolic BP values more than or equal to 85 mmHg should be considered to be increased. Alternatively, you can do an ambulatory BP recording. If that is available with your cardiologist.

Here, we hook on a BP apparatus to your body and that will record the BP every hour for 24 hours. These are more reliable than office BP, which your doctor usually takes. Another indicator of the existence of significant BP is the presence of ECG changes or echo abnormalities.

These are not present in your case. If your home BP or ambulatory BP readings are high, I will definitely suggest a treatment. The decision whether to take cholesterol medicine is based on the total cholesterol and HDL levels. If you have these, then I can tell you if you need to take Rozat (Rosuvastatin). You can do a detailed lipid profile.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Yes, you can send me a BP chart with the timings. Meanwhile, you can start a daily exercise program, which would bring your BP down by about 8-10 mmHg.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.