Despite taking my blood pressure medication, my blood pressure continues to be very high in the morning.  I am very active, and otherwise healthy, and wonder what I can do to control it better?

I am taking irbesartan/Hctz 300/12.5 and atenolol 25mg at noon. Two hours after rising my BP is 182/100 44. In the afternoon it is around 155/90. I had an echo stress test (HR 55 max) and Carotid echo which were all ok. I am very active (serious bicycling). I use CPAP for mild to moderate apnea (AHI =.5). What is causing this steep morning high BP and what can I do to control it?

by Maher M. Nasser, MD

Morning BP is usually higher than PM readings in people with hypertension. Tolerance to some meds may occur with time, meaning they become less effective.

You may have secondary or drug resistant hypertension, and this diagnosis is usually made by your cardiologist or internist. Regards.