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How To Control High BP?

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Posted on Tue, 15 Apr 2014
Question: I'm a 71 year old man with a personal history of hypertension (first diagnosed at age 13) and a family history of strokes. I keep close tabs on my BP with a home BP measuring Omron unit, and I do lots of cycling which helps a lot. My BP goes from something like 113/66 just before galling asleep to around 140/84 halfway through the night, to, say 155/102 upon awakening, when it falls to normal during the day. I thought BP was supposed to FALL at night?
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Answered by Dr. Rakesh Karanwal (44 minutes later)
Brief Answer: Mirtazapine and Tramadol lower the BP Detailed Answer: Hi Mr. XXXXXXX Thanks for posting your query on this forum. Firstly, I fully agree with you that the BP falls to minimal values during sleep and on waking up (which is called Basal BP). However, you have not mentioned the names of drugs and dosages, that you are presently taking for hypertension. This information will be of great help in analyzing your altered BP pattern. Further, in untreated hypertensive patients- particularly those with long-standing hypertension- the BP remains persistently high, irrespective of the time of the day/night. Pending receipt of the medication details, I wish to enlighten you with the fact that, both- Mirtazapine and Tramadol- lower the BP. So, it is apparent that your BP remains under control at bedtime, on account of Tramadol taken during the day and Mirtazapine at night. As the effect of Mirtazapine- taken at night- wanes off, the BP starts rising gradually, culminating to a high BP on waking up (by which time, the effect of Mirtazapine/Tramadol on BP has waned off completely). Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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How To Control High BP?

Brief Answer: Mirtazapine and Tramadol lower the BP Detailed Answer: Hi Mr. XXXXXXX Thanks for posting your query on this forum. Firstly, I fully agree with you that the BP falls to minimal values during sleep and on waking up (which is called Basal BP). However, you have not mentioned the names of drugs and dosages, that you are presently taking for hypertension. This information will be of great help in analyzing your altered BP pattern. Further, in untreated hypertensive patients- particularly those with long-standing hypertension- the BP remains persistently high, irrespective of the time of the day/night. Pending receipt of the medication details, I wish to enlighten you with the fact that, both- Mirtazapine and Tramadol- lower the BP. So, it is apparent that your BP remains under control at bedtime, on account of Tramadol taken during the day and Mirtazapine at night. As the effect of Mirtazapine- taken at night- wanes off, the BP starts rising gradually, culminating to a high BP on waking up (by which time, the effect of Mirtazapine/Tramadol on BP has waned off completely). Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal