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High blood pressure changes during the day

High Blood Pressure Measurement and Monitoring

The treatment of high blood pressure largely depends on blood pressure measurement and monitoring, which is closely related to time: as blood pressure measurement and monitoring would vary at different time throughout a day, multiple measurements throughout a day are required to identify the pattern of blood pressure fluctuation. Most people would present dipper blood pressure characterized by two peaks during 8:00-10:00 am and 4:00-6:00 pm, respectively, and the blood pressure remaining low during the night and reaching the trough during 2:00-4:00 am, followed by gradual rise.

Blood Pressure to Change During the Day

Basic Requirements

At least one blood pressure measurement weekly is required for a hypertensive patient, for healthy people, at least one blood pressure measurement yearly is required, preferably at the time when the blood pressure is at its highest (blood pressure peak), as long as control of the blood pressure peak would be sufficient to keep the blood pressure within the normal range throughout the day. Our goal is to achieve a smooth reduction of blood pressure for 24 hours.

Find out the highest value of blood pressure (Blood pressure peak)

24-hour Ambulatory Blood Pressure Measurement (ABPM) is recommended, it can help you to find out the blood pressure peaking time (the highest value of blood pressure).

If ABPM is not possible, blood pressured can be taken separated during 8:00-10:00am and 4:00-6:00pm. One has to measure personally to determine whether the blood pressure would peak in the morning or in the afternoon, which may vary among individuals.

Once the blood pressure peaking time has been identified, from then on, you should always checked blood pressure during the peak time.

Monitor blood pressure at different time

For high blood pressure patients not possible to receive ABPM, it is preferred to take blood pressure once each in the morning, at afternoon and at night. Some patients may have the blood pressure normal in the day but elevated at night, which is more common in patients who stay up late or who work at night and sleep in the day.

Which arm to take blood pressure from ?

At initial measurement, blood pressures in both the left and right arms are to be measured, where there could be an up to 20 mmHg difference between the two arms; take the blood pressure from the arm with higher measurement and always measure in this arm from then on, which is expected to better reflect your real blood pressure status. A difference greater than 20 mmHg between the two arms indicates the possibility of arterial stenosis in the arm with increased blood pressure, which, if confirmed, is exactly the cause of your high blood pressure. It is therefore important to take blood pressure from both arms.

Take blood pressure at different positions

One blood pressure measurement each in supine, sitting and standing position is preferred whenever possible, where a difference less than 20 mmHg between any two positions is considered normal; otherwise postural hypertension is suspected. It is difficult to identify high blood pressure from a patient whose blood pressure is elevated at supine position yet normal at sitting position, since measurement in sitting position is the routine practice. high blood pressure can be determined in the presence of elevated blood pressure in standing position even when the supine measurement is normal.

Tool for measuring blood pressure

Sphygmomanometer's commonly used type has the mercury ( mercury) column, the spring manner and the electronic sphygmomanometer.
It is recommended to use electronic sphygmomanometer (Electronic Blood Pressure Monitor ) to measure. It's better to pass the international certification.
The three major international certification.
BHS: British Hypertension Society.
ESH: European society of hypertension.
AAMI: United States Association for medical device testing.
Note: certification is the certification of product models, instead of the product name of the certification.

Suggested that individuals do not use mercury column sphygmomanometer. Because mercury column blood pressure monitor contains mercury, this may cause pollution, harm to the health of the family. Mercury is a kind of volatile metal, it is toxic. Because of technical reasons, or improper operation, may cause mercury volatile.

Correct Posture for blood pressure measurement


1. Sit with back straight.
2. The air bag and the right atrium are simultaneously in a parallel line.
3. If the cuff tied too tightly, the measured systolic blood pressure and diastolic blood pressure is a little lower; If the cuff tied too loose, the measured systolic blood pressure and diastolic blood pressure is a little higher. Generally, the cuff can accommodate 2 fingers, the tightness is appropriate.
4. The height difference between the table and the chair is 25-30 cm.

We'll emphasize again

We should develop the habit of monitoring and measurement of blood pressure. For patients with high blood pressure, it is recommended to check blood pressure at least once a week. If you adjust the medication, or you did not control blood pressure very well recently, at this time you need to increase the density of blood pressure monitoring, take blood pressure in the morning, at afternoon and at night, check blood pressure will last for at least a week, or until the blood pressure is normal.

Next Page:
Lifestyle intervention: Lower Blood Pressure Without Drugs

See also:
How do Hypertensive Patients Lower Blood Pressure Stably?
High blood pressure is a silent killer
Prevention of Low blood pressure (hypotension)
Your blood pressure might change throughout the year
Should patients take hypotensive before their return visits to doctor?
Drugs for complications of hypertension
How to Recognize Antihypertensive drugs Side Effects?
The Antihypertensive Characteristics of Antihypertensive Drugs and the Target People
Masked hypertension (high blood pressure)

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