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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment To Control Pressure Increasing In The Afternoon

Is it out of the ordinary to have a blood pressure at 119/75 waking, and through the day getting higher, at times reaching 200/96, then going back down at bedtime after two glasses of red wine and a restful evening? I am an RN and have always thought a flucuation of 15 points is understandable, and acceptable, but this seems crazy. I double check it with others at work and the cuffs I have at home. Started lisinopril back up today, went off because I had the cough back in April so I stopped it and seemed to be asymptomatic. However I keep getting headaches again so I started bk this morning. Just curious when you would expect me to see a difference in the late afternoon pressure. Thank you!
Tue, 2 Feb 2016
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Cardiologist 's  Response
Hello ,
The best means of confirming the diagnosis for hypertension in your case would be doing a 24 hour ambulatory BP monitoring. That's will make our diagnosis certain and help us plan a drug regime because for sure such huge variations are not normal .
even one reading in normal circumstances should not fall into the range above 140/90 . Headache can be explained by the rise in pressure.
As you must know lisinopril may cause cough as it's side effect so angiotensin receptor blocker group (ARB) would be an ideal choice . Valsartan / olmesartan would be the best choice considering their 24 hour action and once daily dosing , which would take care of the fluctuations.
Hoping I ccould help .
Regards Dr Priyank Mody
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Suggest Treatment To Control Pressure Increasing In The Afternoon

Hello , The best means of confirming the diagnosis for hypertension in your case would be doing a 24 hour ambulatory BP monitoring. That s will make our diagnosis certain and help us plan a drug regime because for sure such huge variations are not normal . even one reading in normal circumstances should not fall into the range above 140/90 . Headache can be explained by the rise in pressure. As you must know lisinopril may cause cough as it s side effect so angiotensin receptor blocker group (ARB) would be an ideal choice . Valsartan / olmesartan would be the best choice considering their 24 hour action and once daily dosing , which would take care of the fluctuations. Hoping I ccould help . Regards Dr Priyank Mody