What Does Your Nightime Blood Pressure Tell You About Your Health?
Blood pressure is an important vital sign that gives you essential information about your health. The ordinary pattern of blood pressure is this: your blood pressure is highest in the daytime and lowest at night if you are in good cardiovascular health. This is called blood pressure dipping.
People whose blood pressure does not lower or dip at night are called non-dippers. Non-dippers are at higher cardiovascular risk, which means they are more likely to have heart disease or cerebral vascular disease. Nondippers are likely to have large hearts, thick carotid arteries, artery plaque, brain infarcts, stroke, memory loss, and kidney damage.
The best thing you can do for good blood pressure control is to take care of yourself. Taking care of yourself is self-care. There are particular self-care behaviors or things that you need to do to have good nighttime blood pressure. I will tell you exactly what self-care behaviors you should consider at the end of this post.
Nondipping and Your Biological Clock
Your body has a biological clock that takes care of your sleep-wake cycle and lets you know when you are tired and rested. Melatonin is made by your body and nondippers have shown to have less nighttime melatonin. Therefore, non-dippers are more likely to have and die from a heart attack, stroke, heart failure, or heart disease. Some researchers have found that taking control release melatonin can reduce high blood pressure at night. Control release melatonin might increase your melatonin level decreasing your risk of having or dying from a heart attack, stroke, heart failure, or heart disease.
In 2010, a study was done that showed taking at least one of your blood pressure medications at night increased the life span of the participants. It also gave them better blood pressure control in the daytime and at night. Stroke, heart attack, heart failure, and heart disease risk and was reduced as well. A study was repeated in Spain in 40 primary care clinics and published in 2019. The large well-controlled randomized control trial with over 19 thousand people showed that the risk of death was decreased by 66% and stroke was decreased by 49%. It is thought that nighttime medication dosing turns non-dippers into dippers.
Therefore, if you are a non-dipper, taking your blood pressure medication at night will cause your blood pressure to dip improving your life span.
Nighttime blood pressure monitoring was done with the 24-hour-ambulatory blood pressure monitoring, the gold standard of blood pressure measurement. An interesting fact is that home blood pressure monitoring is as accurate as ambulatory blood pressure. Nighttime blood pressure monitoring is not usually measured with home blood pressure monitoring.
How to Reduce Your Nightime Blood Pressure?
1) Get permission from your doctor to take at least one of your blood pressure medications at night. Diuretic or water pills taken after 4 pm might keep you up during the night giving you poor sleep quality.
2) Turn off your television and electronic devices at least 30 minutes before bed and write in your gratitude journal or read the allegory “Hind’s Feet on High Places” by Hannah Hurnard.
2) Take a 20-minute walk at night no sooner than 2 hours before going to bed to prevent interfering with falling asleep. See this link for instructions on how to walk at home.
3) Take a hot bath at night to improve your sleep and lower your nighttime blood pressure. Add 1/2 a cup of Epson salt for a relaxing bath. Epson salt contains magnesium so be sure to clear this with your healthcare provider before using it.
4) Drink a cup of hot non-caffeine tea at night as part of your nighttime routine to relax you. Chamomile, hibiscus, or green tea may calm you and get you ready for bed, but any decaffeinated tea could help.
5) Ask your doctor if control release melatonin is a good choice for you to help reduce your nighttime blood pressure. Melatonin should be taken with caution in people with auto-immune disease, seizures, or blood thinners. Nifedipine may not work as effectively to lower your blood pressure if you take melatonin. Caffeine could increase the effects of melatonin. Nevertheless, most people do not have any side effects with melatonin, especially when starting out with the lowest dose.
6) Consider getting a 24-hour ambulatory blood pressure monitoring if you are unclear if you are a dipper.
References
Axe, J. (N.D.). Natural Cures for Insomnia | Dr. Josh Axe. YouTube. Retrieved September 8, 2020, https://www.youtube.com/watch?v=s3vaI15ICQg
Grossman, E., Laudon, M, & Zisapel, N. (2011). Effects of melatonin on nocturnal blood pressure: Meta-analysis of randomized controlled trials. Vasc Health Risk Manag, 5, 577-584. doi:10.2147/VHRM.S24603
Dr. Joe TV. (n.d.). Reducing High Blood Pressure Naturally – The Focus. YouTube. Retrieved September 8, 2020,https://www.youtube.com/watch?v=HxsXOkF5tuU&t=11s
Mandell, A. (n.d.). The Miracle Healing Power of Magnesium Sulfate (Epsom Salt Baths) – Dr. Alan Mandell, D.C.YouTube. Retrieved September 8, 2020,https://www.youtube.com/watch?v=I3gjBt0h0Os
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