Pulmonary Hypertension in Children
Four Signs Of High Blood Pressure You Shouldn't Ignore That Can Appear At Night
Some symptoms of high blood pressure can appear at night, disrupting your sleep (Image: Getty)
People have been warned to look out for four signs of a silent killer condition that can appear at night. These symptoms could indicate high blood pressure, also known as hypertension.
It is estimated that around one in three UK adults suffer from high blood pressure, which forces the heart to pump harder to circulate blood throughout the body. The condition is linked to a range of severe health issues including cardiovascular disease, kidney disease, strokes, heart failure, and heart attacks.
Perhaps most concerning is the fact that high blood pressure often remains undetected and untreated until it leads to a critical health crisis, with approximately half of those with hypertension unaware of their condition. The lack of symptoms is one cause of this issue.
Public Health England has labelled high blood pressure as a "silent killer" condition for this reason. And the British Heart Foundation (BHF) warns: "High blood pressure rarely has noticeable symptoms."
If you experience any of these symptoms you should check your blood pressure (Image:
Getty)However, some signs of this dangerous condition can appear at night. Medical News Today reports how some people may experience something called nocturnal hypertension.
As the name suggests, this means that the person's blood pressure goes up at night. This is abnormal as blood pressure "typically decreases" overnight as part of a natural sleep-wake cycle.
Medical News Today explains: "During the day, a person's blood pressure should not be higher than 120/80mmHg. 120 refers to the systolic, or upper number, and 80 to the diastolic, or lower number.
"At night time, elevated blood pressure may exceed 110/65mmHg. Elevated nocturnal blood pressure may contribute to many of the same complications as high blood pressure in general, such as stroke, heart attack, and kidney failure."
Again, many people with nocturnal hypertension may experience no symptoms at all, but it can sleep to some sleep disruptions including:
If you experience any of these signs it is worth checking your blood pressure with a home kit or asking your GP or pharmacist to check it for you. The Centers for Disease Control and Prevention (CDC) says that high blood pressure can develop over time or can be the result of unhealthy lifestyle choices.
Smoking cigarettes can raise your risk of having high blood pressure (Image:
Getty)People living with general high blood pressure may also experience nocturnal hypertension. In terms of general hypertension, the NHS adds that some people may experience symptoms such as headaches, blurred vision, and chest pain, though these are "rare".
According to the NHS, things that increase your chances of having high blood pressure include:
If you are concerned about your blood pressure you should speak to your GP.
Hypertension: Understanding And Managing High Blood Pressure
The human body contains over 70,000 miles of blood vessels, lined by a single layer of endothelial cells. This inner lining, called the endothelium, has a surface area equivalent to 6–8 tennis courts, making it the largest organ in the body. A healthy endothelium is crucial for maintaining smooth blood flow and releasing nitric oxide (NO), a gas that reduces friction in blood flow.
Role of Diet and Atherosclerosis
In infancy, the endothelium is pristine. However, as we grow and consume inflammatory foods, this lining becomes damaged. The body responds by coating the damaged areas with cholesterol, leading to a condition called atherosclerosis. Over time, these deposits narrow the blood vessels, reduce flexibility, and impair the release of NO. This increased resistance raises blood pressure (BP).
With aging, a further complication called arteriosclerosis, occurs as blood vessels harden due to calcification. These changes necessitate higher blood pressure to maintain proper blood flow, particularly after the age of 60–70.
How blood pressure works?
Blood pressure depends on blood volume and resistance. Factors that increase BP include:
•Reduced arterial flexibility.
•Narrower blood vessel openings.
•Higher blood viscosity.
While higher BP in older adults can be a natural adaptation, modern medicine often focuses on lowering it with medications. Unfortunately, few address the root cause—diet.
A Plant Based Solution
Switching to a whole-food, plant-based (PBWF) diet promotes healing. Green leafy vegetables, rich in natural nitrates, improve NO production, enhance blood flow, and clear clogged vessels. Dramatic changes in diet and lifestyle lead to faster recovery. For example, participants in Dr. McDougall's 10-day program in Santa Rosa saw an average BP drop of 17/11 mmHg, with 90% reducing or eliminating medications.
Blood pressure changes over time
Infancy: Average BP starts at 64/41, rising to 95/58 by age 2.
Childhood: With the introduction of inflammatory foods which causes atherosclerosis, BP increases to an average of 110/70 by age 10.
Adulthood: By 16–18, average BP is 120/80, with a normal range of 110–131 over 64–83. After 18, these guidelines remain unchanged, though BP naturally rises with age due to atherosclerosis and arteriosclerosis.
Historical perspective on hypertension
In the past, high BP was not always viewed as dangerous.
•Before 1911, levels up to 210/110 were considered benign.
•In 1937, cardiologist Paul Dudley White suggested that high BP might be a compensatory mechanism and should not always be reduced.
•By the 1960s and 70s, with the advent of medications, treating hypertension became standard, though debate over its necessity persisted.
Hypertension treatment guidelines
The Joint National Committee (JNC) was established in the United States in 1976 to provide blood pressure guidelines. Over the years, these have shifted:
•1997 (JNC-6): Hypertension was defined as BP ≥ 140/90
•2004 (JNC-7): Introduced the concept of "pre-hypertension" (120/80 to 139/89).
•2014 (JNC-8): Relaxed guidelines, recommending BP targets of <150/90 for adults over age 60 and <140/90 for younger adults.
However, these changes reduced pharmaceutical profits and health care providers' income. In response, the American Heart Association (AHA) and American College of Cardiology (ACC) issued stricter guidelines in 2017, lowering the hypertension threshold to 130/80, adding 31 million Americans to those needing treatment. This move reflected financial interests rather than public health priorities.
Problems with aggressive BP management
While lowering BP might seem beneficial, excessive reduction, especially in older adults, increases risks. The "J-Curve" phenomenon, documented in a 2008 study (ACCORD Study) showed no additional benefits in lowering systolic BP below 140.
For individuals over 60, BP medication should only aim for a target of 150/90. Lower targets often result in adverse effects, including increased heart disease risk and reduced life expectancy.
Misdiagnosis & errors
Blood pressure readings are frequently inaccurate due to improper techniques or the "white coat effect" (anxiety in clinical settings). A proper measurement protocol includes:
•Resting for 5 minutes.
•Sitting with back support, feet on the floor, and arm at heart level.
•Avoiding caffeine, smoking, or exercise 30 minutes before measurement.
•Using the correct cuff size and averaging multiple readings.
A 2017 study called Systolic BP Intervention Trial (SPRINT) revealed that "research-grade" measurements (automated, after rest) were 12.7 mmHg lower than routine office readings. Ambulatory monitoring, which tracks BP over 24 hours, provides the most accurate results.
Role of PBWF diet in hypertension management
Switching to a PBWF diet reduces inflammation, repairs the endothelium, and lowers BP naturally within weeks. Compared to medication, dietary changes offer a safer, more effective solution:
•Nitric Oxide production improves, reducing blood vessel resistance.
•The risk of adverse drug reactions and kidney problems is eliminated.
For people over 60, maintaining BP below 150/90 without medication is the optimal goal. Younger individuals should aim for under 140/90.
Conclusion
The modern approach to hypertension often prioritizes pharmaceutical profits over patient health. However, the evidence is clear: a PBWF diet can reverse the root causes of high blood pressure, improving overall health without the risks associated with medication.
For those committed to lifestyle changes, achieving healthy BP levels is one of the easiest, and most rewarding, goals.
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DisclaimerViews expressed above are the author's own.
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For Real, We May Be Taking Blood Pressure Readings All Wrong
For people who had high blood pressure readings only when sitting (normal readings while lying down), there was no statistically significant difference in risk of coronary heart disease, heart failure, or stroke compared to people with normal blood pressure. The only statistically significant differences were a 41 percent higher risk of fatal coronary heart disease (compared to the 78 percent seen in those with high readings lying down) and an 11 percent higher risk of all-cause mortality.
(In this study, high blood pressure readings were defined for both positions as those with systolic readings (the top number) of 130 mm Hg or greater or diastolic readings (the bottom number) of 80 mm Hg or greater.)
The people with the highest risks across the board were those who had high blood pressure readings while both sitting and lying down.
"These findings suggest that measuring supine [lying down] BP may be useful for identifying elevated BP and latent CVD risk," the researchers conclude.
For now, the findings should be considered preliminary. Such an analysis and finding should be repeated with a different group of people to confirm the link. And as to the bigger question of whether using medication to lower supine blood pressure (rather than seated blood pressure) is more effective at reducing risk, it's likely that clinical trials will be necessary.
Still, the analysis had some notable strengths that make the findings attention-worthy. The study's size and design are robust. Researchers tapped into data from the Atherosclerosis Risk in Communities (ARIC) study, a study established in 1987 with middle-aged people living in one of four US communities (Forsyth County, North Carolina; Jackson, Mississippi; suburban Minneapolis, Minnesota; and Washington County, Maryland).
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