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When during the day is blood pressure highest?

Blood pressure has a daily pattern. Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening.

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Does blood pressure have a daily pattern? I've noticed that my blood pressure is always lower in the morning than in the afternoon. Answer From Francisco Lopez-Jimenez, M.D.

Blood pressure has a daily pattern.

Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening. Blood pressure is usually lower at night while sleeping. The blood pressure measurement at night is called nocturnal blood pressure.

Examples of an irregular blood pressure pattern include:

High blood pressure during the night

High blood pressure early in the morning

Less than 10% drop in blood pressure overnight (nondipping blood pressure)

A rise in blood pressure overnight to early morning has been linked to an increased risk of heart disease.

An irregular blood pressure pattern could also mean that you have:

Poorly controlled high blood pressure

Obstructive sleep apnea

Kidney disease

Diabetes

Thyroid disease

A nervous system disorder

Poor diet, lack of exercise and certain lifestyle factors can affect blood pressure pattern, including:

Night-shift work

Smoking

Overweight or obesity

Stress and anxiety

Not taking medications for blood pressure or sleep apnea as directed, or ineffective treatment Your health care provider can tell you if an irregular daily blood pressure pattern needs treatment. Sometimes, a person's blood pressure rises simply when seeing a care provider. This is called whitecoat hypertension. A 24-hour blood pressure monitoring test can be done to measure blood pressure at regular time periods over 24 hours. The test is called ambulatory blood pressure monitoring. It provides a detailed look at blood pressure changes over an average day and night.

With Francisco Lopez-Jimenez, M.D.

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What are the signs of a pre stroke?

Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination. Sudden severe headache with no known cause.

The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Stroke patients may not be eligible for these if they don’t arrive at the hospital in time. If you think someone may be having a stroke, act F.A.S.T. and do the following test:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

Note the time when any symptoms first appear. This information helps health care providers determine the best treatment for each person. Do not drive to the hospital or let someone else drive you. Call 9-1-1 for an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.

What should I do to treat a transient ischemic attack (“mini-stroke”)?

If your stroke symptoms go away after a few minutes, you may have had a transient ischemic attack (TIA), also sometimes called a “mini-stroke.” Although brief, a TIA is a sign of a serious condition that will not go away without medical help. Unfortunately, because TIAs clear up, many people ignore them. But paying attention to a TIA can save your life. If you think you or someone you know has had a TIA, tell a health care team about the symptoms right away.

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