Friday, October 31, 2014
Tuesday, December 09, 2008 Margie, Community Member, asks

Q: What would cause my blood pressure to be so high 160/98 upon waking in the morning?

I have been on 25 mg Topral twice a day for several years. During the past month my blood pressure has been spiking, specifically in the morning upon waking. My Dr. increased my topral from 1 to 2 pills in the evening.. Still high in morning..

Is there something else going on that would cause this. Should I be looking for something wrong with my kidneys.. Bye the way, I just had blood work done and dr. says kidney function is normal but they did find trace of blood and white cells in urine..


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Answers (2)
Neil MD, Health Pro
12/ 9/08 5:56pm

Hello Margie,


A couple of things about your question. 


First, good job on checking your BP at home!


A common cause of high blood pressure early in the morning is from your blood pressure medication essentially wearing off, especially with a medication like a short-acting metoprolol.   Metoprolol is a great medication (its inexpensive, very few side effects, treats a lot of diseases) but is also not great for lowering blood pressure more than 20 mmHg on your systolic blood pressure.  Be sure to mention to your doctor that your BP remains high in the morning.  He may want to try another medication or increase your dose of metoprolol.


Second, without knowing all the numbers on your urinalysis and the rest of your medical history, it's difficult to say what your results mean.  Commonly, a urinary tract infection can cause a lot of white cells and trace blood in your urine.  Be sure to bring these results up, too, with your doctor for your own piece of mind.


To your health,

Neil MD


Lisa Nelson, Health Pro
12/14/08 1:05pm

Hi Margie,


Here's a third possibility:


A higher blood pressure in the morning versus blood pressure readings at other times of the day is an indicator for sleep apnea.  Discuss with your MD.


You can read more about high blood pressure and sleep apnea here (it's page 2 of an article - scroll to bottom for sleep apnea info).


All the best,


Lisa Nelson, RD, LN

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By Margie, Community Member— Last Modified: 11/18/10, First Published: 12/09/08