Increased blood pressure at night: causes and treatment

High blood pressure at night is an unfavorable sign. This form of the disease is accompanied by resistance to drug therapy and a high risk of myocardial infarction. The main causes of nocturnal hypertension are impaired renal function, including diabetes mellitus, apnea (stopping breathing) during sleep, sympathoadrenal crises (panic attacks).

Treatment is selected individually, depending on the etiological factor, preference is given to long-acting drugs.

What blood pressure should a person have at night?

Normally, at night, a person should have a blood pressure of approximately 100-110 mm Hg. Art. for systolic indicator and 60-80 mm Hg. Art. diastolic. This applies to the time period from 2 to 4-5 hours. Then, before awakening, it increases by an average of 10 units. Blood pressure during sleep is lower than during the daytime, due to relaxation of blood vessels and the predominance of inhibition processes in the nervous system.

We recommend reading the article about high heart pressure. From it you will learn about the reasons for the increase in indicators, methods of treatment and prevention, prescribed medications, and dangers for the patient. And here is more information about first aid for high blood pressure.

Salt and pressure

As mentioned above, salt increases blood pressure. This is explained by the fact that due to its excess, fluid is retained in cells and tissues. Such a violation leads to stagnant processes, stress on the heart and deterioration of the condition of the vascular walls. The consequence of this is an increase in blood pressure.

With hypertension, it is especially important to monitor the food you eat. The maximum daily salt intake should not be more than 3-5 grams. This amount should be distributed not only to salt in its pure form, but also to products that contain it. Diuretics are used to remove excess fluid. These can be medications or decoctions prepared at home.

Note. The most effective herbs with a diuretic effect are yarrow, bearberry and dandelion. You can make infusions from them and use them 1-2 times a day. Proportions - 1 tbsp. l dry herb per 300 ml of boiling water.

Causes of increased blood pressure at night

Normally, blood pressure decreases at night, as the activity of the parasympathetic nervous system predominates. According to the figurative expression, “night is the kingdom of the vagus” (vagus nerve). When the processes of regulation of vascular tone are disrupted by the brain or hormones, biologically active compounds, a paradoxical reaction of the arteries occurs in the form of a spasm.

Apnea and nocturnal hypertension

Stopping breathing during sleep is accompanied by a brief drop in oxygen levels in the blood. In this case, the duration of the apnea period is about a minute, and the decrease in saturation (saturation) reaches 65% (with the norm being about 95%). Hypoxia is perceived by the body as severe stress, which provokes the release of adrenal hormones, increased cardiac output and constriction of arterial vessels.

With hypertension associated with apnea, patients report fatigue and irritability in the morning, daytime sleepiness, and heart rhythm disturbances.

Features of the disease are:

• increased blood pressure mainly at night and in the morning;
• moderate increase in daily indicators;
• the diastolic (lower) indicator increases to a greater extent;
• lack of effect from traditional antihypertensive therapy.

Nephropathy and increased blood pressure during sleep

One of the signs of renal origin of hypertension is a nocturnal rise in pressure. This is due to an increase in the content of renin produced by the kidneys and the launch of a chain of biochemical reactions. As a result, the flow of hormones and active compounds into the blood increases. They cause generalized arterial spasm (angiotensin 2) and sodium and water retention (aldosterone) in the body.

Hypertension at night can also occur with diabetic nephropathy. It is detected even earlier than protein in the urine. Therefore, daily monitoring of blood pressure can prevent the progression of this complication of diabetes leading to severe kidney failure.

Watch the video about high blood pressure and its causes:

Sharp jumps in older people

An increase in blood pressure is not a natural result of aging, but with age the following changes appear that contribute to hypertension:

• decreased elasticity of the walls of the aorta and arteries;
• deposition of collagen and elastin fibers in the vascular membranes;
• calcification of the arterial bed;
• loss of the ability to respond to internal and external stimuli by changes in the lumen of blood vessels;
• decreased blood circulation in the kidneys, glomerular sclerosis;
• low sensitivity of baroreceptors that respond to blood pressure;
• decreased blood flow to the brain.

The result of involutional processes is a weak response to vasodilatory influences, persistent arterial spasm, and activation of renin-angiotensin-aldosterone mechanisms.

A characteristic sign of nocturnal hypertension in older people is a tendency to sudden changes in blood pressure levels. There is a predominant increase in the systolic indicator.

Predisposing factors

Some lifestyle features can lead to nocturnal hypertension:

• emotional stress, stressful situations, especially in the evening;
• playing sports late;
• smoking;
• night activity - loud music, watching movies or reading after midnight, using electronic gadgets;
• eating salty, sweet or fatty foods before bed, drinks with caffeine or alcohol, drinking plenty of water;
• change in climatic conditions, time zones;
• night shifts at work, frequent business trips.

Excess weight, uncomfortable head position, especially with problems with the cervical spine, and hot flashes during menopausal disorders can affect the increase in blood pressure at night.

What should your blood pressure be like at night? 4 profiles

One of the readers in the article Arterial hypertension: summary of European recommendations 2020 found the phrase:

Night-time BP (blood pressure) levels are a better predictor of cardiovascular events than daytime BP.

The reader had a question about what blood pressure should be at night compared to during the daytime. In this article I will tell you how blood pressure should change at night and what problems may lie here.

Circadian blood pressure cycles

Changes in blood pressure levels during the day have general patterns

both in healthy individuals and in patients with arterial hypertension.

• The morning peak in blood pressure occurs between 6 a.m. and 12 a.m. (which is why most antihypertensive drugs must be taken early in the morning to have time to work).
• This is followed by a slight decrease and stabilization of blood pressure levels.
• The evening peak in blood pressure is lower than the morning peak and occurs around 19:00.
• Then blood pressure decreases. Minimum numbers are observed from midnight to 4 am.
• After 4 am, blood pressure gradually increases and then increases sharply 1 hour before waking up.

Normally, from 4 to 10 o'clock the morning rise rate is

systolic blood pressure should be less than 10 mm Hg. Art. per hour, diastolic - less than 6 mm/hour. The total rise should not exceed 56 and 36 mmHg. Art. respectively.

Morning is the only period during the day when increased clotting

blood. Patients with cardiovascular diseases are more likely to experience cardiovascular accidents (heart attacks and strokes).

At night, average blood pressure should decrease by an average of 10-20% compared to daytime pressure. The person is lying down or sleeping, he is relaxed, so high blood pressure is not required. But if the patient works the night shift or does not sleep, blood pressure at this time almost does not decrease and may even increase compared to daytime.

24-hour blood pressure monitoring (ABPM)

For comparison, average daytime and average nighttime values ​​obtained during ABPM

(24-hour blood pressure monitoring). For ABPM, the patient wears an automatic blood pressure monitor for a day or longer, which turns on regularly, usually every 15-30 minutes during the day and every 30-60 minutes at night, pumps air into the cuff, measures blood pressure and stores the readings in the internal memory for subsequent analysis.

Standards for average blood pressure values

according to ABPM data recommended by the Russian Medical Society for Arterial Hypertension and the All-Russian Scientific Society of Cardiologists:

• during the day: from 100/60 to 140/90 mm Hg. Art.,
• at night: from 86/47 to 125/80 mm Hg. Art.

24-hour blood pressure monitoring is a simple but very useful test. ABPM allows you to calculate several indices (coefficients) and clarify the risk of complications or the likelihood of developing hypertension in doubtful cases.

There is a story on the Internet about daily blood pressure monitoring. Now I went to the cardio center. We hung up a device for daily blood pressure measurement. A cuff on the arm and a motor in the purse. Periodically measures blood pressure. On the way back, we found out some two guys - like who is he, where is he from, is there any little things? So we were standing around, talking, the situation was heating up, and then this little motor started humming—the cuff was pumping. Out of surprise, I straightened up and froze (I forgot something about him). These two guys also stared at me in amazement - suddenly it started buzzing, and my left arm was pumping up before my eyes! Then the engine stalled, and I, in a robotic voice, with a glazed look into nowhere, said: “Combat mode is on.” How they ran away... You had to see it!

4 groups (profiles)

Although blood pressure should drop by 10-20% at night, in reality different situations are possible.

According to the degree of reduction in nocturnal blood pressure in the English and Russian scientific literature, 4 groups (profiles)

of people:

• dippers
  , or dippers (English dip - to go down, dive, dive) - at night blood pressure is 10-20% less than during the day. This is the norm. This reduction should occur in healthy people;
• overdippers
  , or overdippers (English over - too, too much) - at night blood pressure decreases by more than 20%. If blood pressure is initially low, an excessive decrease may be dangerous;
• non-dippers
  , or non-dippers (the particle non means negation) - nighttime blood pressure does not decrease enough, by no more than 10%;
• night-peakers
  , or night-peakers (English peak - peak, top) - night blood pressure rises above daytime blood pressure. This is a rare, but most unfavorable situation in hypertensive patients.

When assessing the results of nighttime blood pressure monitoring, you must definitely pay attention to periods of time without sleep, restless sleep, and getting up. For example, turning from one side to the other leads to an increase in blood pressure by 20 mmHg. Art. The patient should reflect these points in a diary, which is kept in parallel with ABPM.

Now let's learn more about each group and what it means.

Dippers

A decrease in blood pressure at night by 10-20% (dippers) is a normal and desirable situation. Some authors include here a reduction in blood pressure even up to 22%. In patients with the dippers profile, the blood pressure graph at night looks like a bucket-shaped depression.

Overdippers

If nighttime blood pressure is on average lower than daytime blood pressure by more than 20-22%, such subjects fall into the overdippers group. With a sharp and excessive decrease in blood pressure at night, the likelihood of fainting (and injury) when getting up to go to the toilet increases, as well as the risk of ischemic complications (lack of blood supply) to the brain and heart. Episodes of hypotension

periods of time with blood pressure below 90/60 mm Hg are considered. Art. during the day and below 80/50 mm at night. If the patient is being treated for hypertension, the treatment should be adjusted.

Non-dippers

A decrease in blood pressure at night of less than 10% (non-dippers) gives a “monotonous” daily graph of blood pressure levels over time. There is no significant decrease at night. This is an unfavorable situation that often occurs with secondary hypertension

(due to some other disease), for example:

1) with renovascular

hypertension. Blood pressure is persistently and persistently elevated and is difficult to treat. This occurs when the renal arteries are narrowed (stenosis) by 50-70% or more, when the kidneys are poorly supplied with blood and increase the production of renin to increase blood pressure and improve their blood flow. There are 2 main causes of narrowing of the renal arteries:

• 80% (more often in men) have atherosclerotic stenosis
  (due to the abundance of atherosclerotic plaques). It has been established that if a patient has atherosclerosis of the arteries of the heart or lower extremities, then with a 40-45% probability he will also have damage to the renal arteries;
• 20% (more often in women) have fibromuscular dysplasia
  . This is an abnormal thickening of the artery walls that is not associated with atherosclerosis or inflammation. The reason is unknown. The narrowing can be single or multiple and alternate with areas of dilation of the artery (aneurysm). Fibromuscular dysplasia can also affect the arteries of the brain, stomach and intestines, and lower extremities.

Rare causes of renal artery stenosis include:

• embolism (blockage by a detached blood clot),
• injuries,
• dressing during operations,
• compression of the renal artery by a tumor.

2) primary hyperaldosteronism

(Conn's syndrome) also gives a “monotonous” blood pressure graph without a clear decrease at night. Conn's syndrome is caused by a benign tumor of the adrenal gland that secretes aldosterone uncontrollably. Excess aldosterone leads to sodium and water retention in the body (edema) and loss of potassium in the urine (blood potassium levels below 3.5 mmol/L are accompanied by muscle weakness and ECG changes).

3) pheochromocytoma

- a benign tumor of the adrenal glands that uncontrollably releases the hormones adrenaline and norepinephrine into the blood. There is a paroxysmal form (BP increases in the form of characteristic attacks with a feeling of fear, anxiety, trembling, sweating, palpitations, headache, nausea) and a permanent form (BP is constantly increased).

4) with malignant

arterial hypertension.

This is a very high, persistently elevated blood pressure (above 180/120 mm Hg) with damage (necrosis) to the walls of blood vessels, which can lead to strokes, papilledema (vision loss), ischemia and dysfunction of various organs. The vast majority of cases of malignant hypertension are caused by damage to the kidneys, renal arteries or hormonally active tumors (pheochromocytoma, primary hyperaldosteronism);

5) for diabetes

(due to hyperglycemia, the innervation of the heart and blood vessels is disrupted);

6) after transplantation

(heart transplants);

7) with chronic renal failure (chronic renal failure);

for sleep apnea syndrome (more about it below).

Night speakers

If blood pressure is higher at night than during the day

oh, this is the rarest, but at the same time the most unfavorable situation. Normally, neither children nor adults have a night-peakers profile.

The reasons are the same as for the non-dippers profile, but I will separately mention sleep apnea syndrome

. During sleep, due to relaxation of the body muscles, the walls of the pharynx collapse and block the path of air. Apnea occurs (a period of no breathing when air cannot enter the lungs). Apnea lasts on average 20-30 seconds. Then, due to a lack of oxygen in the blood, the respiratory center is activated, a partial awakening occurs with an increase in the tone of the muscles of the pharynx and the restoration of its patency. This sounds like a snore followed by a series of rapid, deep breaths, usually accompanied by heavy snoring. The patient then falls back into deep sleep and the cycle repeats. During the night there are up to several hundred cycles of stopping and resuming breathing. Deep phases of sleep completely or partially disappear. The patient does not sleep well, but is not aware of his micro-awakenings and does not remember them the next day.

One of the subjective signs of sleep apnea syndrome is a feeling of shallow, unrefreshing sleep.

. Patients get up in the morning sleep-deprived and often feel very sleepy during the day.

Sleep apnea syndrome occurs:

• in 90-95% of people with severe obesity (body mass index greater than 35);
• those who snore during their sleep (not all snorers have sleep apnea syndrome, but this syndrome practically does not exist without snoring);
• during pregnancy,
• in women during menopause.

There will be a separate article about sleep apnea syndrome.

The dangers of insufficient blood pressure reduction at night

High blood pressure has a devastating effect on arteries and target organs

(brain, heart, kidneys, eyes). If blood pressure is elevated at night, the pathological process accelerates. As a result, they develop:

• hypertrophy of the left ventricular myocardium (in the future this contributes to arrhythmias and the development of chronic heart failure),
• IHD (coronary heart disease) and increased mortality from myocardial infarction,
• strokes,
• kidney damage with the appearance of albumin in the urine (microalbuminuria) and the development of renal failure,
• retinopathy (damage to the retina of the eye).

Was the material useful? Share the link:

Panic attacks and increased blood pressure at night

Neurocirculatory dystonia with increased activity of the sympathetic part of the autonomic system can be accompanied by crises that occur at night. Such conditions are called panic attacks and are associated with an intense release of adrenal hormones into the blood. Clinical manifestations of nocturnal attacks:

• sudden awakening
• a rush of sweat,
• strong and frequent heartbeat,
• unreasonable fear, anxiety,
• feeling of lack of air.

This attack lasts from 10 minutes to half an hour. After its completion, the urge to urinate appears. For a day or more after the attack, patients report severe weakness and decreased performance.

Treatment

It is necessary to constantly monitor blood pressure levels. If nocturnal hypertension occurs, therapy should be comprehensive, aimed at eliminating the causes of the disease. The choice of drugs, dosage, recommendations for use are determined only by the attending physician. Diuretics are widely used to lower blood pressure. They remove excess fluid from the body.

To reduce capillary tension and slow the heart rate, beta blockers are prescribed. It is necessary to control renal pressure - regulation of blood circulation in the urinary system is possible with the help of angiotensin inhibitors. Calcium antagonists help lower blood pressure - drugs in this group expand the lumen of blood vessels, blocking calcium channels. You can learn about the differences between renal and cardiac pressure in this article.

The patient must strictly adhere to the instructions of the attending physician, take medications regularly and on time, while simultaneously monitoring blood pressure. In the initial stage of the disease, you can use other methods to reduce blood pressure: physical therapy complexes and massage, decoctions and infusions of medicinal plants, acupuncture. Do not forget about adjusting your lifestyle and abandoning harmful stereotypes. Adequate physical activity and proper, balanced nutrition are required. It is necessary to identify and treat concomitant diseases in a timely manner.

Why does blood pressure rise during sleep?

If, instead of decreasing, blood pressure rises during sleep, then this is regarded as hypertension, even if it is normal during the day. Risk factors for high rates are insomnia, night shifts.

What does resting hypertension mean?

Resting hypertension is an increase in blood pressure between 11 pm and 3 am. Detection of the disease is possible only by monitoring indicators - hourly measurements.

For this, special equipment is used, since the very fact of waking up the patient for measurements causes an increase in values ​​and an inaccurate result. During the treatment process, it is still recommended to take at least one measurement per night at least 2 times a week, as well as determining a person’s blood pressure immediately after sleep to assess medication doses.

Why does hypertension increase blood pressure during sleep?

Hypertension is characterized by increased blood pressure during sleep. This is due to dysregulation of vascular tone by the autonomic nervous system. Normally, the activity of the parasympathetic department should predominate, then the arteries will expand and the pressure will decrease. In hypertensive patients, the sympathetic department is more active. This can be a reaction to:

• frequent stress;
• physical and emotional stress;
• stopping breathing during sleep (night apnea syndrome);
• smoking;
• drinking coffee, energy drinks, alcohol, especially in the evenings;
• insufficient physical activity.

Does blood pressure rise if you don't sleep?

If you don't sleep at night, your blood pressure always rises instead of falling. This is due to brain activity, the formation and release of stress hormones into the blood. They cause constriction of blood vessels and an increase in blood circulation rates.

Insomnia in hypertension is one of the reasons for the worsening of its course, the occurrence of crises, and a risk factor for such severe consequences as myocardial infarction and stroke. The combination of sleep disorders with other provoking conditions is especially dangerous:

• smoking;
• elderly age;
• menopause;
• widespread atherosclerosis (angina pectoris, cerebrovascular accidents).

Insomnia with hypertension can trigger a stroke

Is blood pressure related to sleepless nights and night shifts?

It has been proven that sleepless nights and night shifts negatively affect blood pressure (BP), as they cause:

• deterioration of the nervous system;
• vascular damage;
• depletion of the body's adaptive reserves;
• circulatory disorders in the heart;
• increased release of adrenaline and cortisol, released during a stress response.

During sleep, the hormone melatonin is produced. It also helps reduce blood pressure, as it reduces the activity of the sympathetic part of the nervous system and inhibits the formation of substances with a vasoconstrictor effect. With a lack of sleep, such changes do not occur or they are insufficient.

What to do and how to treat?

Increased pressure at night should not be ignored; it must be reduced at the initial stage of development of the disorder. To determine the cause of the deviation, contact a cardiologist who will conduct a comprehensive examination and select optimal therapeutic measures. Sometimes it is enough to adjust your daily routine, exclude the computer in the evening and other factors that influence changes in blood pressure. It is equally important to normalize the food and drinking regime. You should exclude from your daily diet junk food and alcoholic drinks that worsen heart function. Patients should not consume coffee or other products containing caffeine before bedtime. You should also refrain from physical activity in the evening, which accelerates cardiac function.

Drug treatment

To eliminate the patient's problem, the doctor may prescribe Lasix.
If lifestyle correction is ineffective, then it is possible to reduce high blood pressure or low blood pressure through medications. Medicines must be prescribed by the attending doctor and taken by the patient in a strictly prescribed dosage. The table shows commonly used medications for sleep disturbances.

Unconventional treatment

Peppermint can be used to prepare a folk medicine.
In order not to be bothered by nighttime increases in blood pressure, patients resort to natural ingredients that help stabilize blood pressure. With this problem, you can prepare decoctions and tinctures using medicinal plants and herbal preparations. Such means must be used with caution to prevent the situation from worsening and the development of other unpleasant consequences. The following components are useful for low blood pressure during sleep:

• chamomile inflorescences;
• St. John's wort;
• peppermint;
• yarrow;
• lovage

To prepare a medicine that normalizes blood pressure during sleep, you need to take all the ingredients in equal quantities and place them in a thermos. Pour boiling water over the herbal mixture and let stand for at least 2 hours. After preparation, use the folk remedy internally instead of tea. To improve the taste, you can add a slice of lemon or a spoonful of honey to the medicine. If you constantly take the medicinal product, you will be able to cope with disruptions in blood pressure that bother you during night sleep.

Why does blood pressure rise at night but be normal during the day?

Blood pressure may rise at night or in the evening, even with pills, but during the day it remains normal, and the main reasons for the phenomenon are:

• incorrectly selected dose of medication;
• insufficient frequency of administration;
• a combination of 2-3 drugs is needed;
• During the day there are frequent stressful situations, high mental stress with a lack of movement;
• there is abuse of coffee, nicotine, alcohol;
• nutrition is based on spicy, salty, fatty, sweet foods with a lack of vegetables, berries, fruits;
• There was a disruption of biorhythms due to frequent night work, late viewing of films, and the use of electronic gadgets.

If your blood pressure rises at night, it is important to change the antihypertensive therapy regimen and take the main dose in the evening rather than in the morning. This type of therapy often leads not only to the normalization of night indicators, but also reduces the risk of acute disorders of cerebral and coronary (cardiac) circulation.

Diagnosis of nocturnal hypertension

Now it has become clear why blood pressure rises at night during sleep. Sometimes it is very difficult to identify high blood pressure numbers, since blood pressure and well-being remain normal during the day. For this purpose, it is necessary to conduct daily blood pressure monitoring (ABPM). This procedure will tell you in detail about the pressure figures during the day: periods of increase, decrease, pulse rate, dependence on physical activity, medication, and so on.

Additionally, the doctor may prescribe blood and urine tests, an ultrasound examination of the kidneys, and an electrocardiogram. If an isolated increase in blood pressure only at night is confirmed, then the next step will be to search for the cause of hypertension.

Why does blood pressure rise in the evening in older people?

In older people, blood pressure rises in the evening due to vascular changes. The main reasons are related to the hardening of the arterial wall and its tendency to spasm. Narrowing and atherosclerotic lesions of the renal vessels lead to insufficient blood flow. In response, the kidneys increase the formation and release of compounds with a vasoconstrictor effect into the bloodstream.

Atherosclerotic lesions lead to insufficient blood flow

The maximum activity of this system (renin-angiotensin-aldosterone) is observed in the evening.

With hypertension in old age, it is especially important to monitor morning indicators, since at this time there is the highest risk of acute circulatory disorders. If they are often higher than normal, then you should definitely contact a cardiologist to adjust the dosage of medications. You cannot change medications and treatment regimens on your own. Older people are characterized by sharp fluctuations in blood pressure when they do not take medications; they are dangerous for the blood vessels of the brain.

Signs of nocturnal hypertension

Many people sometimes do not even realize that they are developing hypertension. This happens due to the fact that the pathology begins to reveal itself with symptoms that appear only at night. Some patients often attribute poor health in the morning to fatigue, overwork, and do not attach any importance to alarming signs.

Blood pressure may rise during nighttime sleep

In fact, the reason for feeling unwell after waking up is a sharp jump in blood pressure during sleep. After such a violation in the morning, a person feels bad due to the following:

• Nausea and dizziness;
• Headaches and lethargy;
• Increased irritability.

In addition, the disease can cause sleep disturbances, frequent unexplained awakenings in the middle of the night, regular panic attacks at night and difficulty breathing. All these symptoms almost always signal that a person has health problems.

Note. Nocturnal hypertension is a very dangerous pathology that can lead to sudden death during sleep. Therefore, it is important to recognize the symptoms in time, not ignore them, and consult a cardiologist in a timely manner.

Why does women's blood pressure rise at night?

In women, blood pressure rises at night when menopause occurs. When it is severe, hot flashes, sweating, and rapid heartbeat occur at night, often accompanied by an increase in blood pressure. To normalize the condition, replacement therapy with female hormones or their herbal analogues is recommended.

At a younger age, the cause of increased nighttime readings is often metabolic syndrome. It is characterized by hypertension, obesity, metabolic disorders of carbohydrates (increased glucose levels with sugar load), fats (high cholesterol). To successfully normalize blood pressure, it is imperative to reduce weight through diet and physical activity, and if necessary, medications are added to them.

Disease prevention

It is known why blood pressure begins to rise when lying down, and how to treat it. But how to prevent it?

To do this, it is enough to adhere to general preventive measures:

• avoid stressful situations;
• exclude fried foods that contain refractory fats;
• control the salt content in the diet;
• quit smoking and alcohol;
• take a walk in the fresh air;
• give up caffeine-containing products, coffee and black teas;
• increase consumption of fish and dairy products, vegetables, fruits;
• every meal should be light;
• Do not have dinner immediately before bed.

Pulse and blood pressure rise sharply at night: reasons

When the pulse and blood pressure rise sharply at night, this may be a manifestation of symptomatic arterial hypertension. To exclude it, it is important to check the functioning of the thyroid gland, adrenal glands, and kidneys. The causes of such attacks are:

• hyperthyroidism, thyrotoxicosis - excess thyroxine produced by the thyroid gland;
• disease, Itsenko-Cushing syndrome - increased production of cortisol by the adrenal cortex;
• pheochromocytoma - a tumor of the adrenal medulla that produces stress hormones;
• pyelonephritis, glomerulonephritis, polycystic kidney disease.

Pyelonephritis is one of the causes of increased blood pressure and pulse

Drug treatment

Treatment of nocturnal hypertension must be comprehensive, so most often several drugs from different groups are prescribed. It can be:

• ACE inhibitors;
• Diuretics;
• Beta blockers;
• Calcium antagonists.

The doctor selects the drugs and their combination based on the severity of the disease, the patient’s age and taking into account the individual characteristics of the body.

Important! Very often, patients begin to use medications for high blood pressure on their own. However, starting treatment with any medications without a doctor’s prescription is strictly prohibited. In order for medications to bring maximum benefit, you need to select them correctly and calculate the required dosages. Only an experienced specialist can do this.

The dangers of high night pressure

The period between three o'clock in the morning and six o'clock in the morning is considered the most dangerous for the development of vascular accidents. One of the main causes of acute pathologies is a sharp increase in blood pressure. During this period, the following most often occur:

• sudden cardiac arrest,
• extensive myocardial infarction,
• ischemic and hemorrhagic stroke,
• atrial fibrillation and ventricular fibrillation,
• pulmonary embolism.

If there is no expected reduction in blood pressure at night, then the organs do not have time to recover from daytime overload, this contributes to the progression of blood supply disorders to target organs - the myocardium, kidney tissue, and brain. It has been established that with an average increase in blood pressure at night by 8 - 12 mm Hg. Art. the risk of death from hypertension increases by 20 - 22%.

Myocardial infarction may be a consequence of nocturnal increases in blood pressure

Characteristic symptoms

A decrease or increase in blood pressure at night during sleep can be accompanied by a different clinical picture, which depends on the source and severity of the underlying disorder. A sharp jump cannot be ignored, since it is accompanied by pronounced symptoms. Signs of blood pressure disturbances during sleep are presented in the table.

If there is a sharp jump in pressure towards a decrease, the person may lose consciousness. In this case, first aid is required to prevent unpleasant consequences.

Seeing a doctor and diagnosis

The difficulty of diagnosing the nocturnal form of arterial hypertension leads to the fact that the diagnosis is made mainly at the stage of complications. Therefore, for patients with symptoms of night awakenings and feelings of weakness in the morning, it is recommended to measure blood pressure in the evenings and in the morning immediately after sleep. In this case, a mandatory condition is to carry out measurements before using the drugs; only in this case can a reliable result be obtained.

If in the evening and in the morning the readings are not only not lower than during the day, but there is also a tendency to increase, you need to urgently consult a cardiologist.

For additional examination, the following is prescribed:

• automatic blood pressure monitoring using special devices;
• urine and blood tests;
• Ultrasound of the kidneys, blood vessels of the head and neck;
• study of oxygen content in the blood during sleep (pulse oximetry);
• ECG in Holter monitoring mode, with physical and pharmacological stress tests.

Symptoms

Symptoms of nocturnal hypertension will vary depending on the stage of the disease. According to blood pressure indicators, there are 3 stages of disease development:

• 160/100;
• 180/100;
• 180/110 and above.

The initial stage may last several years. As the disease progresses, it develops into the second form. Blood pressure may remain elevated at night for weeks. At the development stage, characteristic symptoms are fatigue after sleep, headache, heaviness in the forehead, bridge of the nose, a feeling of constriction in the chest, and sleep disturbances.

The second stage is characterized by disruption of the structure and functionality of cardiovascular tissues.

It is accompanied by:

• shortness of breath even after minimal physical activity or in its absence;
• pain under the ribs on the left;
• headache, reminiscent of squeezing, swelling;
• deterioration of vision at the time of increased pressure.

In the UAM (general urinalysis), protein is determined. When examining the fundus, distinct changes are visible. The third stage is characterized by irreversible pathologies of the cardiovascular system and brain. The symptoms of the third stage do not go away even with normalization of blood pressure.

When a diagnosis of hypertension is made, the symptoms will be: partial paralysis, numbness of the extremities, regular loss of consciousness, disturbance of sleep patterns (usually nocturnal hypertensive patients sleep during the day), migraine, memory impairment, partial memory loss is possible, decreased hearing and vision acuity.

Treatment and lifestyle

In order to maintain stable blood pressure at the recommended level throughout the day, the following medications are used:

• long-acting (half-life more than 24 hours);
• capable of firmly blocking ion channels and adrenergic receptors;
• in the form of special dosage forms with gradual release.

When monitoring blood pressure in patients with nocturnal hypertension, an interesting property of medications was discovered - the time of taking the drug affects the duration and severity of the hypotensive effect.
For example, Valsacor, taken at night, de-energizes normal blood pressure at night, in the morning and during the day, but taking it in the morning does not give the same result. Similar data are available for Amlodipine.
If you drink it at night, your daily levels will be lower than if you take it before breakfast. Therefore, for patients with nocturnal pressure surges, it is necessary to keep a self-monitoring diary to determine whether the dose taken is sufficient and whether it needs to be transferred to the night.

All patients with a tendency to increase blood pressure in the evening or morning should take their last meal no later than 4 to 5 hours before bedtime. In this case, dinner should be light and include mainly boiled vegetables, lean meat or fish. Just before going to bed, it is better to avoid eating and drinking; it is especially important to avoid salty, fatty and spicy foods, coffee and alcohol.

In the evening, an active lifestyle is not recommended; walking, a warm shower, and foot massage with oil with a few drops of lavender or ylang-ylang have a good effect.

Features of treatment

Therapy for nocturnal hypertension depends on the stage of the pathology. At the initial stage, lifestyle correction and medications prescribed by a doctor are sufficient. The goal is to reduce the load on blood vessels.

Medications

It is recommended to reduce nighttime blood pressure slowly: by 25% in a couple of hours, no more. Prescribing or stopping medications on your own is dangerous. For nocturnal hypertension use:

Self-administration of diuretics is undesirable, as this can lead to leaching of calcium from the body. As a supplement, B vitamins are prescribed, which restore nerve cells, and magnesium – normalizes heart rhythm.

ethnoscience

After consultation with a doctor, use traditional medicine:

It is impossible to get rid of high blood pressure forever, since the walls of blood vessels adapt to it and do not return to normal even with the help of pills. However, preventing complications is a real task.

Nutritional Features

Nocturnal hypertension, especially grade 2-3, requires a salt-free diet. In addition, it is necessary to calculate an individual drinking regime, which also contributes to minimal water retention in the body (approximate norm is a liter of water).

Your doctor will help you choose a balanced diet based on treatment table No. 10. If a hypertensive crisis occurs at night, it is better to refuse food for a day. Then, exclude any broths for a week, eating only vegetables and fruits.

Psychological relief

It can be easily done at home. Effective:

• pets, gardening;
• slow dancing, culinary club, embroidery, fishing - favorite hobbies;
• relaxation: yoga, meditation, music, drawing, modeling, the sound of waves, birds singing on a disk - everything that pacifies;
• massage - only as an addition to relaxation: light classic or acupressure (strong vibration increases blood pressure);
• baths with relaxing, soothing fillers: mint, lavender, pine needles or a soft shower - tropical shower;
• rejection of bad habits;
• light dinner: vegetables and fruits or dairy option: kefir, cottage cheese, sour cream;
• sleep hygiene: room ventilation, comfortable pillow, orthopedic mattress, waking up and going to bed at the same time;
• communication with grandchildren.

It is necessary to be able to get rid of negative thoughts, recharge with vigor and positive emotions.