Patient's Query
Hi doctor,
I was prescribed Amlodipine 2.5 mg in urgent care due to high blood pressure. My question is: while on this medication, my blood pressure readings in the morning and night are usually in the low 130s, sometimes even in the 120s. However, in the afternoon, my readings can be in the 140s. Then, at night, my readings go back to the 130s. I am a 36-year-old male. What does this mean? What is my correct blood pressure?
Kindly assist.
Hello,
I am glad you chose icliniq for your medical-related queries.
I can understand your concern.
When your blood pressure is around 140 mmHg while at rest, it is certainly high for your age. Although most of the time your blood pressure is in the normal range, it is notably high during midday.
Blood pressure varies throughout the day and depends on many factors such as external environment, mental and physical stress, workload, level of exertion, and overall health. Blood pressure increases with activity and stress (both physical and mental) and returns to a lower range when a person is at rest. Factors like the exertion you do, the stress you experience, and the food you consume all play a role in blood pressure fluctuations.
In addition to medication, blood pressure can be controlled and maintained through daily walking, exercise, weight reduction, reducing salt intake, avoiding processed and junk foods, and using salt substitutes. If you follow these measures along with your current medication, it should help keep your blood pressure in the normal range. The dosage of your medication could be slightly increased to maintain normal blood pressure, though it may be too soon to make changes right now, provided you follow the recommended measures. Research suggests that losing 2.2046 pounds in weight can decrease blood pressure by 2 mmHg.
I hope this has helped you. Please feel free to reach me again, in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
With the current medication that I am on , I am just nervous I am not doing enough. I do not want to up the dose just like that . Do you have an explanation why it goes higher by day ? And if it goes higher due to physical and mental activity is that dangerous or the fact that morning and night is calmer and it is in a better range suffice
Hi,
Welcome back to icliniq.com.
As you mentioned, regulatory hormones typically start secreting and become active in the morning, surge by midday, and then decrease as the day progresses. You are right that mornings and evenings are generally calmer than midday, which can impact blood pressure.
If your blood pressure remains high for extended periods (weeks, months, or years) it can eventually cause damage to organs.
I suggest taking your medication regularly and following instructions, especially focusing on weight reduction and reducing salt intake. Also, try to cut back on caffeine and nicotine if you use them. Give it a couple of weeks, and your blood pressure should move into a normal range. Amlodipine can be increased from 2.5 mg to 5 mg, and further adjustments can be made if necessary.
I recommend a comprehensive check-up with your local general practitioner (GP), including a physical examination and basic laboratory such as a complete blood count, serum creatinine, serum electrolytes, and any other tests your GP advices based on your examination.
You can always come back and reach me at icliniq.com.
Thank you for consulting me.
Patient's Query
Hi doctor,
Thank you for the reply.
Would you increase it to 5 mg at this point, or is it safe to continue with 2.5 mg?
Hi,
Welcome back to icliniq.com.
I would suggest continuing with 2.5 mg for a week, along with the lifestyle changes I have recommended. Follow up with blood pressure charting, which means recording your blood pressure twice daily for a few days. If the readings are still above normal, Amlodipine can then be increased to 5 mg.
You can always reach me at icliniq.com.
Thank you for consulting me.
Patient's Query
Hi doctor,
Thank you for the reply.
I do get readings in the 130s during the day. I just cannot figure out why I might get a reading of 147 and then, a few minutes later, get a 135 and then a 145. While readings in the 130s are acceptable, I am confused by the fluctuations. If it is stress and activity-related, is it still not healthy? I do not know how to evaluate this.
Hi,
Welcome back to icliniq.com.
Blood pressure fluctuations from time to time are normal. However, if these fluctuations go beyond what is considered normal, they should be controlled. Blood pressure readings should be taken twice daily, preferably in a quiet and calm place and at the same time each day, usually a couple of hours after meals and caffeine intake. Frequent readings taken one after another are not recommended. A standard method is to use a 24-hour ambulatory blood pressure monitor, which your local cardiologist might arrange. This will provide an average blood pressure reading that can be used to determine if treatment is needed.
According to the American Heart Association, normal blood pressure is less than 120/80 mmHg. Blood pressure up to 139/89 mmHg is considered elevated, and readings above that are classified as hypertension, which should be managed through lifestyle changes and medication. It is advised to continue your medication, adopt the recommended lifestyle changes, and monitor your blood pressure as instructed.
You can always reach me at icliniq.com.
Thank you for consulting me.
Patient's Query
Hi doctor,
Thank you for the reply.
Why is my first reading always higher, and then it gets lower and lower? Maybe when I am sitting and relaxing, it goes down. But is the pressure after sitting and relaxing the real pressure, or is it the pressure I get when I take it right away (which is probably the pressure I have when I am up and about, so I am thinking)?
Please help.
Hi,
Welcome back to icliniq.com.
Blood pressure checks should be done while sitting after 5 to 10 minutes of rest, with feet resting on the ground, back supported by the chair, and hand at heart level on the table. At home, this method is the correct way to check your blood pressure.
Another type of BP check is ambulatory blood pressure monitoring, where a device is attached to your body by your cardiologist and left there for 24 hours. It records your blood pressure during resting periods, working periods, exertion, while driving, walking, and others. Multiple measurements are taken, and a mean is calculated. This type of monitoring is performed by a cardiologist or trained physician and is used when blood pressure readings are normal at rest but there is suspicion of hypertension.
You can always come back and reach me at icliniq.com.
Thank you for consulting me.
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Answered byDr. Wajahat
Medically reviewed byiCliniq medical review team
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