Blood pressure varies throughout the day and often increases around the time of waking up.

However, some medications, health conditions, and lifestyle factors can lead to unusually high morning blood pressure, known as morning hypertension.

Morning hypertension can increase the risk of heart attack and stroke. These medical emergencies often occur in the early hours when blood pressure rises.

In this article, we explore the causes and effects of morning hypertension. We also look at ways in which people can prevent and control this condition.

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Some potential causes of morning hypertension include the following.


Some people take antihypertensive medications to control their blood pressure. According to a 2018 review, uncontrolled morning hypertension may indicate a problem with the type or dosage of these medications.

Specifically, morning hypertension may be due to one or more of the following factors:

  • taking a medication dosage that is too low
  • taking short-acting or intermediate-acting medications rather than long-acting medications
  • taking a single antihypertensive medication rather than a combination of medications

Some people may find that taking their medications before bed rather than in the morning improves blood pressure control. Others may need to split their daily dose, taking half in the morning and half before bed. Sometimes, a person may need to change to another type of blood pressure drug altogether.

It is important to speak with a doctor before changing medications.

Medical conditions

Certain medical conditions may increase the risk of hypertension. These include:

Lifestyle factors

Certain lifestyle factors can also increase the risk of hypertension. Examples include:

  • smoking
  • heavy alcohol consumption
  • eating a diet high in salt and saturated fat
  • not getting enough exercise

Blood pressure refers to the force with which the heart pumps blood around the circulatory system.

Blood pressure also rises and falls throughout the day and night. During sleep, blood pressure falls. It then increases around the time of awakening. In some people, this increase may be significant, resulting in morning hypertension.

Several factors can influence blood pressure, including:

Typical levels

A blood pressure monitor uses a unit of measurement called millimeters of mercury (mm Hg) to measure the pressure inside the blood vessels. A typical blood pressure reading is less than 120/80 mm Hg.

Readings between 120/80 mm Hg and 139/89 mm Hg indicate that a person is at risk of developing hypertension, while readings of more than 140/90 mm Hg signify hypertension.

High blood pressure typically does not cause symptoms, even when levels are dangerously high.

Certain symptoms are more common in people with hypertension. However, they do not necessarily occur as a direct result of hypertension. These symptoms include:

Diagnosing high blood pressure in the morning typically relies on a person’s self-reported readings.

Depending on what these readings show, a doctor may recommend a 24-hour blood pressure monitoring test. This test involves wearing a device that takes regular blood pressure readings throughout the day and night.

The doctor will also review the person’s medical history and carry out a physical examination. If necessary, they may order additional tests to confirm or rule out a diagnosis. Examples include:

  • an echocardiogram, which is an ultrasound of the heart
  • an electrocardiogram to trace the heart’s electrical activity
  • blood tests
  • urine tests

The following factors can increase a person’s risk of developing morning hypertension:

  • being over the age of 65 years
  • being of African or Caribbean descent
  • having a relative with high blood pressure
  • having overweight or obesity
  • drinking alcohol
  • smoking
  • anxiety or excessive stress
  • insufficient sleep
  • disturbed sleep, for example, working night shifts

People with morning hypertension are at higher risk of cardiovascular events than those with typical morning blood pressure readings.

Getting morning hypertension under control can reduce the risk of heart attack, stroke, and other cardiovascular events.

Treating hypertension involves addressing its underlying cause.

For example, If morning hypertension is due to issues with blood pressure medications, a doctor must fix this problem. Doing this may involve changing the dosage or the time of the day that the person takes the medication. In some cases, a doctor may recommend taking additional medications.

In many cases, lifestyle changes can help treat hypertension and improve overall heart health. Doctors may recommend the following:

In other cases, it may be necessary for a person to take anti-hypertension medications. These include:

Learn more about the medications for hypertension.

Following a healthy lifestyle can help control hypertension in the morning and at other times of the day. Managing hypertension will help lower the risk of complications, such as heart attack and stroke.

Suitable lifestyle behaviors include:

  • eating a balanced diet that is low in sodium, refined sugar, and saturated fat
  • limiting alcohol intake
  • avoiding tobacco, if applicable
  • exercising regularly
  • practicing stress management and relaxation techniques, such as yoga or meditation
  • taking blood pressure medications according to the prescription
  • treating any underlying medical conditions that may contribute to hypertension

Below are answers to common questions relating to blood pressure levels throughout the day.

What time of day is blood pressure highest?

Blood pressure typically rises in the hours before waking up and increases throughout the morning, peaking at midday.

How long after you wake should you take your blood pressure?

There is no set time limit a person should wait to take their blood pressure after waking. A person can help account for blood pressure changes throughout the day by measuring in the morning and afternoon to get an average reading. The most important factor in timing measurements is finding a time someone can stick to routinely.

Blood pressure fluctuates throughout the day and night. It naturally increases in the hours around waking.

However, atypically high blood pressure readings in the morning can indicate that someone is at increased risk of cardiovascular events.

Careful monitoring of blood pressure can alert people to instances of morning hypertension. Healthy lifestyle behaviors and prompt medical treatment may help prevent heart attack, stroke, and other complications of hypertension.