How Is Resistant Hypertension Treated
Treatment options for resistant hypertension or pseudo-resistant hypertension depend on your underlying conditions and how well you tolerate various medications. Treatments include:
- Addressing any conditions that may have caused the hypertension.
- Making lifestyle changes
- Adjusting medications to find your optimal type and dosage
Latest High Blood Pressure News
FRIDAY, April 17, 2020 — Nighttime high blood pressure could harm the brain, a new study says.
Most people’s blood pressure goes down during the night, which is called dipping. But in some people, it stays the same or even rises — called reverse dipping.
Folks with high blood pressure and reverse dipping may be at increased risk for vascular damage in the brain and associated memory problems, according to the study published online April 15 in the journal Neurology.
“It appears that reverse dipping may amplify the effects of high blood pressure on people’s cerebrovascular health and associated cognitive abilities,” said study author Adam Brickman, professor of neuropsychology at Columbia University.
“These results add to the mounting evidence that shows the importance of vascular risk factors in contributing to memory problems,” he said in a journal news release.
The study involved 435 people, average age 59. Their blood pressure was monitored for 24 hours at home with a device that took readings every 15 minutes during the day and every 30 minutes at night.
The participants also underwent brain scans and tests of their memory and other thinking skills.
— Robert Preidt
Blood Pressure Measuring Tips
Consider that when your blood pressure is being measured, your arm should be at the level of your heart. If the arm is hanging down whether you are sitting or standing, the arm should be extended out. If you are lying down, the arm should be along your side, leveled with your body.
Aside from being aware of your arm position, here are some other tips to keep in mind when having your blood pressure measured:
- Rest for about five minutes before the reading is taken.
- Try not to eat or exercise for 30 minutes before a screening.
- Have your reading in the morning, since your bodys rhythms can cause blood pressure to rise in the afternoon and evening.
- Have your pressure taken from all three positions: sitting, standing, and lying down.
- Have your blood pressure taken three times in one session with one minute of rest between each test.
Dont get caught up in comparing your blood pressure to others. Instead, know that there is a healthy blood pressure level for each sex and specific age. Here you can find an age and gender chart you can check to see what your healthy range is.
Monitoring your blood pressure on a regular basis can give you the most accurate picture of what is happening with your blood pressure. There are some common factors that can impact your pressure readings. Many are related to lifestyle and include smoking, diet, and physical activity level. Family history can also play a role, as can stress.
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A Few Things To Know About Sleep And Your Health
Youve gone in for your routine physical examination, and youre told what millions of Americans have already been told: You have high blood pressure. But, like many Americans, you may not be aware of the truth behind the powerful connection between blood pressure spikes and the quality of your sleep.
The truth is that lack of sleep can cause high blood pressure; sleep apnea may play a role; and you should know what might be behind a sudden spike of high blood pressure at night.
How Dangerous Is High Blood Pressure?
High blood pressure, also known as hypertension, is classified as Stage One or Stage Two. Stage One hypertension is a reading of 130/80 mm Hg or above, while Stage Two has readings of 140/90 mm Hg or above. Anything exceeding 180/120mm is considered a medical emergency.
If youve been diagnosed with hypertension, or youve just experienced a sudden spike in blood pressure, youre far from alone. In fact, according to the CDC, 45 percent of adults in the United States experience high blood pressure, and only a quarter of those have their blood pressure properly being treated.
Blood pressure can have a dramatic impact on your health, especially if you have chronic hypertensionbut even sudden spikes in high blood pressure can contribute to the following.
Can Lack of Sleep Cause High Blood Pressure?
Sudden Spikes In Blood Sugar Overnight Are Something That Diabetics Dont Want To Ever Experience
Something like this happening blood sugar soaring while youre sound asleep and totally unaware is a frightening thought.
But people who do not have diabetes dont have to worry about very high rises in blood sugar during sleep.
Actually, sugar can spike in anyone, but in people with normal sugar metabolism, no one notices, says Susan L. Besser, MD, with Mercy Medical Center, Baltimore, and Diplomate American Board of Obesity Medicine and board certified by the American Board of Family Medicine.
The cause is normal fluctuation in body glucose and metabolism, continues Dr. Besser.
Even though we are asleep at night, the body is still working, still using energy.
At night we arent eating while we sleep , so the body has to use stored sugar to feed itself.
These stores are found in the liver and are released through a hormonal process. In most of us this is used immediately so the sugar doesnt spike.
In someone with diabetes, glycogen is converted to blood sugar , and this happens with everyone but with diabetics the body cannot use this glucose, so the sugar rises.
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What Is The Relationship Between Sleep Apnea And Blood Pressure
Of the two types of sleep apnea, only OSA is linked to high blood pressure. CSA isnt a known cause of hypertension, but it develops in 30 to 50% of people with heart failure.
The prevalence of OSA is estimated to be between 4 and 7% of the general population, but it affects 30 to 40% of people with hypertension. Of people diagnosed with OSA, it is estimated that around half also have high blood pressure.
In healthy individuals, blood pressure naturally lowers by between 10 and 20%; at night, a phenomenon that is sometimes referred to as blood pressure dipping. People with severe OSA experience blood pressure dips of less than 10%, which indicates a nondipping blood pressure pattern.
People who have nondipping blood pressure at night face an increased risk for cardiovascular issues. Additionally, many patients with OSA experience a sudden and pronounced elevation of their blood pressure when they wake up in the morning. This morning surge is another factor that may increase risk for cardiovascular disease. Moderate to severe OSA increases all-cause and cardiovascular mortality.
OSA doesnt only affect blood pressure at night. Studies show that daytime blood pressure levels also increase with sleep apnea severity.
Wrong Medication Or Wrong Dose
For each person theres an ideal combination of medications and dosages that would best control their hypertension. Some people havent yet received that ideal combination. Its important to work with a doctor who is familiar with the range of medications and who knows what works best for each individual.
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How Sleep Apnea Affects Blood Pressure
High blood pressure, also called hypertension, is a common health issue in which the amount of force that pumps blood through blood vessels is higher than normal. People with hypertension often dont have symptoms but learn they have high blood pressure during routine checks at a doctors office. If left untreated, high blood pressure puts a daily strain on the cardiovascular system which may lead to stroke, heart disease, and other conditions. Fortunately, managing hypertension with medication and lifestyle changes can reduce your risk for harmful health effects.
Sleep apnea is a sleep disorder that causes numerous lapses in breathing during sleep. There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea . OSA is marked by episodes of airway collapse, which blocks airflow into the lungs and often causes snoring and gasping during sleep. In CSA, breathing lapses occur because of a lack of communication between the brain and the muscles involved in breathing.
Its important to understand the relationship between hypertension and sleep apnea because these two conditions affect one another, and treatment for sleep apnea can lower blood pressure in people who have both.
What Happens To Blood Sugar While You Sleep
Itâs tied to whether the hormone insulin, which removes glucose from the blood, is working the way itâs supposed to. Blood sugar levels surge while youâre sleeping, usually around 4 to 8 a.m. for someone with a normal sleep schedule. In a healthy person, insulin can handle the surge by telling muscle, fat, and liver cells to absorb the glucose from the blood, which keeps your levels stable.
For people who have diabetes or who are likely to get it, insulin canât do that job very well, so blood sugar levels will rise higher.
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Sleep Habits And Diabetes
While diet and obesity are big contributors to your odds of having diabetes, studies have found that sleep habits are, too, probably because over time, they can affect how well your cells respond to insulin.
In one study, more than 4,000 people reported the amount of sleep they got each night. Those who got less than 6 hours were twice as likely to have cells that were less sensitive to insulin or to have full-blown diabetes. This was true even after the researchers took other lifestyle habits into account.
Other sleep disruptions and disorders, such as sleep apnea, also seem to raise a personâs odds of having diabetes.
But the risk goes up at the other end of the spectrum, too. For reasons that arenât clear, people who sleep too much — more than 9 hours a night — might also have higher chances of getting diabetes.
Sleepless Nights Linked To High Blood Pressure
- University of Arizona
- A bad night’s sleep may result in a spike in blood pressure that night and the following day, according to new research led by the University of Arizona. The study, to be published in Psychosomatic Medicine, offers one possible explanation for why sleep problems have been shown to increase the risk of heart attack, stroke and even death from cardiovascular disease.
A bad night’s sleep may result in a spike in blood pressure that night and the following day, according to new research led by the University of Arizona.
The study, to be published in the journal Psychosomatic Medicine, offers one possible explanation for why sleep problems have been shown to increase the risk of heart attack, stroke and even death from cardiovascular disease.
The link between poor sleep and cardiovascular health problems is increasingly well-established in scientific literature, but the reason for the relationship is less understood.
Researchers set out to learn more about the connection in a study of 300 men and women, ages 21 to 70, with no history of heart problems. Participants wore portable blood pressure cuffs for two consecutive days. The cuffs randomly took participants’ blood pressure during 45-minute intervals throughout each day and also overnight.
At night, participants wore actigraphy monitors — wristwatch-like devices that measure movement — to help determine their “sleep efficiency,” or the amount of time in bed spent sleeping soundly.
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Symptoms Of Sudden High Blood Pressure
Unlike traditional high blood pressure, where there are no visual symptoms until major damage has occurred, sudden high blood pressure alerts you immediately.
- Weakness or numbness in arms, legs, face
- Mentality changes such as anxiety, fatigue, confusion, restlessness
In extreme cases of sudden high blood pressure, there may be bleeding from damaged blood vessels, blindness from ruptured retina nerves or vessels, and possibly seizures.
Blood Pressure Spike Whilst Asleep
Hi, I have noticed through a ambulatory blood pressure monitor that my blood pressure spikes in the middle of the night on a regular basis. My watch takes blood pressure hourly and I can go from normal sometimes even low BP to high into hypertension range within an hour. Is it normal for blood pressure to spike like this whilst asleep?;
0 likes, 10 replies
Posted 4 years ago
The problem is treating BP that spikes. If you treat the highs the lows would go;too low
Posted 4 years ago
Your blood pressure is naturally lower while you’re asleep to your lowest point of the day. The spikes could be caused by snoring, breathing irregularities or dreams and nightmares. I go to sleep worried thinking about things and it affects my sleep too.
I don’t have anything that monitors me during the night just yet but I would ask the doctor if I were you just see what his opinion is.
Posted 4 years ago
The most qualified person to ask about this is your doctor. You mentioned that your ‘watch takes bp hourly”..you wear a wrist bp monitor??? If so, their accuracy is very questionable. Is there a reason why you’re taking your bp while sleeping?????
Again, if you’re concerned, please see your doctor.
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Beware Of Blood Pressure Changes At Night
When systolic blood pressure jumps up by 20 mm/Hg or more during the night, the risk of heart disease and stroke goes up by 18% and the risk of heart failure increases by 25%.
If people consistently had higher blood pressure readings at night, but normal readings during the day, the risk of heart failure more than doubled. The researchers, writing in the journal Circulation, dubbed this a “riser pattern.”
On the other hand, for people with a drop in blood pressure of more than 20%, the study team noted a more than twice the risk of stroke. They called this group “extreme dippers.”
“Nighttime blood pressure is increasingly being recognized as a predictor of cardiovascular risk,” study lead author Dr. Kazuomi Kario said in a journal news release. He’s chair of cardiovascular medicine at the Jichi Medical University in Tochigi, Japan.
Dr. Raymond Townsend, an expert volunteer for the American Heart Association, said blood pressure is typically higher in the morning and lower in the afternoon and evening.
Compared to the overall daytime blood pressure pattern, “blood pressure is generally about 10% to 20% lower during sleep. Sleep time offers a relatively pure look at blood pressure. Most factors that influence blood pressure are minimized during sleep,” he explained.
What Are The Best Sleeping Positions For High Blood Pressure
Not everyone agrees on the best sleeping positions for high blood pressure, but;sleep specialist, and medical director of the;Martha Jefferson Hospital Sleep Medicine Center, W. Christopher Winter,;says that;sleeping on the left side;is the best sleeping position for high blood pressure because it relieves pressure on blood vessels that return blood to the heart. These vessels are located on the right side of the body and may become compressed slowing your;circulation if you sleep on your right side. Sleeping on your left side is important for pregnant women concerned with high blood pressure. Because the growing baby presses against internal organs and may cause circulation issues, sleeping on the left side will help with circulation and may prevent high blood pressure.
According to research conducted by;Yasuharu;Tabara;and his colleagues from the;Ehime;University School of Medicine in;Ehime, Japan,;sleeping face down;may be the key to lowering blood pressure while you sleep. Results of their study indicated that blood pressure may drop more than 15 points when you change from sleeping face up to face down.
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Osa And Resistant Hypertension
OSA is common in patients with resistant hypertension, which is defined as BP that remains uncontrolled with three or more medications. In a prospective evaluation of 41 patients with resistant hypertension, Logan et al found that 96% of the men and 65% of the women had significant OSA . In 71 consecutive subjects referred to the hypertension clinic at the University of Alabama at Birmingham for resistant hypertension, we found that 90% of the men and 77% of the women had OSA . As OSA severity increases, there is an increased need for additional BP medications; that is, the more severe the OSA, the less likely BP is controlled with pharmacologic therapy.- A prospective, but uncontrolled CPAP trial demonstrated that CPAP use can have substantial antihypertensive benefit in patients with resistant hypertension. Logan et al reported that CPAP use after 2-month follow-up in 11 patients with resistant hypertension lowered nighttime systolic BP by 14.4±4.4 mm Hg and diastolic BP by 7.8±3.0 mm Hg.
Resting Heart Rate During The Night
Nightly average RHR varies widely between individuals. A normal heart rate can range anywhere from 40 to 100 beats per minute and still be considered average. It can also change from day to day, depending on your hydration level, elevation, physical activity, and body temperature. As with many of your bodys signals, its best to compare your RHR with your own baseline. Avoid comparisons to those around you.
When looking at your RHR curve, pay special attention to these three things:
- Your trend: Does your RHR go up, down, or stay level during the night?
- Your lowest point: When is your RHR lowest?
- Your end: Right before you wake up, does your RHR change?
With these questions in mind, here are three patterns you may recognize in the night-time heart rate curves you can see with Oura:
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