Is Blood Pressure Higher in the Morning?

High blood pressure, or hypertension, affects nearly half of adults in the United States. Because blood pressure changes and fluctuates throughout the day, many people believe that it’s normal to have higher blood pressure in the morning.

However, high blood pressure can put you at risk for cardiovascular disease and stroke, which are leading causes of death in the U.S. That’s why it’s important to understand what a normal reading looks like and what factors can cause your blood pressure to rise.

So, is it normal to have elevated blood pressure in the morning? And how can you know if your blood pressure is ideal? Read on to find out.

What is Blood Pressure?

Blood pressure is the force or pressure of blood pushing against the walls of your arteries, which are in charge of carrying blood from your heart to other parts of your body. Without blood pressure, oxygen and nutrients would not be able to circulate throughout your body.

‍High blood pressure, or hypertension, occurs when your blood pressure is higher than normal. If your blood pressure is consistently high, your doctor may diagnose you with hypertension. Hypertension can have negative effects on the body. Over time, it can cause serious damage to your arteries, your heart, your brain, and your kidneys. It can also increase your risk of heart failure, heart attack, and stroke.

Because high blood pressure has no symptoms or warning signs, it’s important to have your blood pressure checked by your doctor regularly.

How is Blood Pressure Measured?

Blood pressure is measured using two numbers: systolic and diastolic blood pressure.

• Systolic blood pressure measures how much pressure your blood is exerting against your artery walls when your heart beats.
• Diastolic blood pressure measures how much pressure your blood is exerting against your artery walls when your heart rests between beats.

Systolic blood pressure tends to rise steadily with age, while diastolic blood pressure can sometimes remain in the healthy range. This condition (known as isolated systolic hypertension) is the most prevalent in people over 50, and it can occur as plaque builds up in your arteries over time.

Your systolic and diastolic blood pressure levels are used to diagnose high blood pressure, but the guidelines can vary depending on your health care professional. You may be diagnosed with hypertension stage 1 if your blood pressure levels are consistently 130/80 mmHg or higher.

‍Hypertension stage 2, which is more severe, can be diagnosed if your blood pressure levels are consistently 140/90 mmHg or higher. Both an elevated systolic or diastolic blood pressure reading may be used to diagnose high blood pressure.Here are the standards for blood pressure levels according to the American Heart Association:

Causes of High Blood Pressure

There are many causes of high blood pressure, including age, certain health conditions, and some prescription medications. Health conditions that may lead to high blood pressure include:

• Kidney disease or long-term kidney infections
• Diabetes
• Obstructive sleep apnea
• Hormone problems, including underactive or overactive thyroid or increased levels of certain hormones
• Lupus

Medications that may lead to high blood pressure include:

• Birth control pills
• Certain steroids
• Non-steroidal anti-inflammatory drugs (NSAIDS), like ibuprofen and naproxen
• Some serotonin-noradrenaline reuptake inhibitors (SSNRI), which are used to treat depression

Risk Factors For High Blood Pressure

You may be at higher risk for developing high blood pressure if you:

• Obesity
• Consume excess sodium while being salt-sensitive
• Drink too much alcohol, coffee, or other caffeine-based drinks
• Don’t get enough exercise
• Smoke cigarettes
• Are over the age of 65
• Have a family history of high blood pressure
• Have irregular sleep patterns

Because the symptoms of high blood pressure are hard to detect, it’s important to have your blood pressure checked regularly. You can do home blood pressure monitoring using a blood pressure cuff or visit your primary care physician.

So, Is Blood Pressure Naturally Higher in the Morning?

While it’s true that blood pressure follows a daily pattern, this does not mean that your blood pressure should be high in the morning. In fact, morning hypertension might be linked to an increased risk of heart disease.

In a typical blood pressure pattern, your blood pressure starts to rise a few hours before you wake up and rises throughout the day, peaking at mid-day, before dropping back down. Though your blood pressure does start to rise in the morning, it should remain in the normal range — below 120/80 mmHg.

Some people diagnosed with hypertension may experience what’s called a morning blood pressure surge, where their blood pressure rises in the early morning hours. The reasons for this surge aren’t well known, but studies suggest that this morning surge may be an independent risk factor for cardiovascular events like heart attacks. It can also increase stroke risk, as well as lead to damage to the heart, kidneys, and brain.

The morning blood pressure surge among people with hypertension may also be the reason why morning hours are the time of day when most major cardiovascular events happen. If your blood pressure is consistently high in the mornings, you should see your doctor or healthcare professional for next steps.

Monitoring Your Blood Pressure at Home

To monitor your blood pressure at home using a blood pressure cuff, the American Heart Association has these tips:

1. Rest for at least five minutes before measuring your blood pressure. Make sure your bladder is empty and don’t smoke, drink caffeinated drinks, or exercise within 30 minutes before measuring. 

2. Sit upright with your back straight, feet flat on the floor, and make sure your legs aren’t crossed.Your arm should be supported on a flat surface, like a table, with your upper arm at heart level.

3. Place the cuff directly on your skin and make sure it is sitting right above the bend of your elbow. Follow the instructions of your blood pressure cuff to make sure you’re doing it properly.

4. Measure your blood pressure at the same time every day. Blood pressure follows a daily pattern, so measuring at the same time every day will give you an accurate reading.

5. Take multiple readings and record the results. When you measure, take two or three readings one minute apart and write down your results.

A diagnosis of high blood pressure should be confirmed by your doctor or healthcare provider. If you have concerns, you may want to bring your readings to an appointment to be evaluated.

What If You Have a High Blood Pressure Reading?

It’s important to remember that a single high reading isn’t an immediate cause for alarm. If your reading is slightly or moderately higher than usual, take your blood pressure a few more times and talk to your doctor or a medical professional.

If your blood pressure exceeds 180/120 mmHg, test again after five minutes. If it's still unusually high after the second reading, and you experience chest pain, shortness of breath, back pain, numbness or weakness, changes in vision, do not wait to see if your pressure comes down on its own.

A blood pressure reading over this amount might indicate a hypertensive crisis, which is when blood pressure quickly rises to 180/120 mmHg or higher. A hypertensive crisis can have serious consequences, including heart attack or stroke, so seek care right away.

Tips For Preventing High Blood Pressure

High blood pressure is a serious medical issue, but there are a few lifestyle factors you can implement to prevent it apart from taking blood pressure medications.

Eat a Healthy Diet 

Focusing on foods rich in potassium, fiber, and protein and avoiding foods high in added sugars, and saturated fats may help you keep your blood pressure low.

Limiting salt if you are salt sensitive may also be helpful, though there is controversy surrounding advice on sodium reduction and whether or not it should be restricted to people with hypertension or applied population-wide.

For some people, it may also be a good idea to avoid sodium intake dropping too low. Some studies show an increase in stroke at low sodium levels and that sodium response follows a J-shaped curve, where very low and very high intakes may both be detrimental.

The Dietary Approach to Stop Hypertension (DASH) eating plan advises the following:

• Eating vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, poultry, beans, and nuts/seeds.
• Limiting foods high in saturated fats, including fatty meats, coconut oil, and palm oil.
• Limiting sugar-sweetened beverages and sweets.

Maintain a Healthy Weight

Being overweight or obese can increase your risk for high blood pressure. The CDC suggests getting at least seven hours of sleep a night, prioritizing a diet full of nutrient-rich foods. Getting regular physical activity alongside a healthy diet can help you maintain your weight and has a number of other health benefits too.

Stay Physically Active

Physical activity has been shown to help lower blood pressure. Aim to get at least two and a half hours of moderate-intensity exercise, like walking or bicycling, per week.

Get Enough Sleep

Sleep deficiency is linked to high blood pressure. Experts recommend that adults get at least seven hours of sleep a night. There are a few things you can do that might improve your sleep, including:

• Going to bed and waking up around the same time every day, even on weekends
• Keeping the room where you sleep dark, quiet, relaxing, and cool
• Keeping a consistent bedtime routine that does not include screens, like showering, reading, or journaling before bed

Limit Your Alcohol Intake

Drinking too much alcohol can negatively impact your blood pressure. Men are advised to limit their alcohol intake to no more than two alcoholic drinks per day, while women are advised to stick to one alcoholic drink per day.