The Morning Surge – Why High Blood Pressure In The Morning Is a Health Threat

Last reviewed:
21 Apr 2023
Medically reviewed by:

Why High Blood Pressure In The Morning Is a Health Threat

Picture this: you helped your family member take a reading of their blood pressure last night. It was 149/91mmHg. This morning?


“Is that… normal?” you think. Should we be concerned? Or concerned, concerned?

For those with hypertension and their families, seeing a sudden spike in blood pressure starts to sound alarm bells. So, today we’ll discuss the reasons why high blood pressure in the morning can occur and when it signals danger.

What Is “The Morning Surge”?

The morning surge is a temporary increase in blood pressure. Typically, this takes place between the hours of 6 AM and 12 PM.

Explore the literature and you’ll soon find a theme – the morning blood pressure surge is a significant risk factor associated with cardiovascular disease and acute medical events.

It’s important to note that higher blood pressure during the morning hours is to be expected… to a point. Confused?

Let us explain. As the Mayo Clinic describes, a normal daily blood pressure pattern looks like this:

  • Your blood pressure gradually increases in the hours before waking
  • It peaks around midday
  • It falls through the late afternoon and is lowest at night

Say somebody has a healthy blood pressure reading of 120/80 mm Hg. If their systolic blood pressure rose upon waking from 120 to 123 or their diastolic blood pressure rose from 80 to 82, that’s normal. No worries there.

However, if somebody else who’s already classified as having hypertension experiences an exaggerated morning surge in blood pressure, that’s when it can indicate a real problem.

Recommended reading: Does the time of day affect blood pressure?

Why High Blood Pressure in The Morning Affects Some People More Severely

Numerous factors make the morning surge in blood pressure more probable and problematic for certain individuals.

Here are a few factors that can have an impact:

  • Age
  • Alcohol consumption
  • Arterial stiffness
  • Caffeine consumption
  • Cortisol levels
  • Ethnicity
  • Medication
  • Mental and physical activity
  • Nitric oxide
  • Platelet aggregation
  • Seasons of the year
  • Sodium intake
  • Sympathetic nervous system
  • Tobacco use

Cardiovascular events (such as heart attacks) and strokes are most likely to happen in the 6 AM – 12 PM hours. Particularly for older people with hypertension, advanced cardiovascular disease is associated with an increased morning blood pressure surge.

Elderly people with high blood pressure aren’t the only ones at risk though.

Research in the Journal of Hypertension describes how the morning blood pressure surge isn’t merely a consequence of hypertension. It’s causal and can lead to organ damage, atherosclerosis, or trigger cardiovascular events.

7 of The Main Symptoms of High Blood Pressure in The Morning

There’s a reason why high blood pressure has the unfortunate label of being a “silent killer.”

Noticeable symptoms can be subtle or even non-existent. This makes it hard for both the person with hypertension and their family members to know when a crisis is at hand.

That being said, here are seven of the more obvious (and ominous) morning symptoms that could indicate a surge in blood pressure is out of control:

  • Chest pain
  • A severe headache
  • Shortness of breath
  • Nausea or vomiting
  • Blurred or double vision
  • Dizziness or feeling faint
  • Seizures (this is rare but can happen in some cases)

No doubt, these symptoms can result from different health issues.

For example, a bout of nausea may be relatively harmless if you ate something that upset your stomach. But if you or a loved one has high blood pressure and experiences 2-3 of the above symptoms together, don’t dismiss them. Contact your medical practitioner or an emergency line to get checked.

5 Strategies to Consider If You Find Your Blood Pressure Is Higher in The Morning

Okay, so you or someone you care for has raised blood pressure. You also find it’s higher in the morning. Now what?

As stated, if the jump in systolic or diastolic blood pressure is critical or unexpected, this may require urgent medical attention. If the increase isn’t large, it may be more appropriate to consider which morning habits you can tweak to lower blood pressure over time.

Here are five to try out:

1) Ace your breakfast.

A protein-packed and fibre-rich breakfast does a couple of great things for your body. First, it keeps you feeling full for longer so you’re less likely to snack on unhealthy foods in between meals.

Moreover, research shows that increasing dietary fibre intake both lowers blood pressure and reduces the risk of cardiovascular disease.

2) Drink 1-2 glasses of water in the first hour of waking (and avoid caffeine if you can bear to!)

Eight glasses. That’s the amount of water per day we’re advised to drink each day. Most people don’t meet this goal. Not only does drinking a couple of glasses of water in the morning help towards your daily target, but it also flushes out excess sodium. And as we know, consuming too much sodium is known to increase blood pressure.

Topping up with water in the morning also fills your stomach, meaning you may be less tempted to go straight from bed to the coffee machine. Failing that, detox tea or coffee is a healthier way to start the day for those with hypertension.

3) Stress less, move more.

Easier said than done, we know.

Stress can build in the morning at the thought of a long day ahead with lots of to-dos to fight your way through. Exercise is your stress-busting friend here.

Physical activity before midday will burn calories and support your cardiovascular health, as well as get rid of built-up emotional tension.

If a morning workout isn’t realistic for mobility reasons or a lack of time, there are other ways to de-stress. A 5-minute meditation, a gentle 10-minute walk with no distractions, or a series of deep breaths can all help to get your blood pressure down.

4) Keep up with your medication.

Many people with hypertension are prescribed medication by their doctor to keep their blood pressure under control. Yet, medication adherence can be a struggle. In studies, less than 50% of people take their medications as prescribed. The most common reasons for this?

Forgetfulness and procrastination.

If you are on a blood pressure medication — or caring for someone who is — it’s vital to have a system in place that provides reminders to keep taking it according to the correct schedule.

5) Don’t rely on unreliable methods of measuring blood pressure.

Health analytics tools are progressing at a rapid rate, so don’t be surprised if the “old-school” blood pressure cuff gets phased out in the years ahead.

No question, the cuff is a useful device. It’s better than not measuring blood pressure at all. But there are clear flaws in the method.

For one, the readings often aren’t a true reflection of average blood pressure. Many people feel more on edge or anxious before their blood pressure is measured, causing it to be higher than normal. Even seated position and bladder fullness can impact the readings!

Another flaw is the timing. Taking a reading in the middle of the night (when blood pressure is usually lowest) isn’t possible without setting an alarm to wake up and disturbing sleep. It’s not a feasible long-term strategy.

That being said, what can you use instead?

Wear the Aktiia bracelet for 24/7 blood pressure monitoring, all on autopilot. It’s validated by five clinical trials and 20+ peer-reviewed papers with more than 50 million successful blood pressure measurements to date.

Before you ask…

  • Is it comfortable to secure around your wrist? Yes.
  • Does it measure blood pressure day and night? Yes.
  • Is it easy to share the data with your doctor or family members? Yes.

Unlike other blood pressure measurement methods, using Aktiia is super easy!

So, if you’re concerned your or a family member’s blood pressure may surge in the morning, take away the guesswork and get the round-the-clock insights you need. Feel free to explore Aktiia further here.

Disclaimer: If you are concerned about your blood pressure, it is best to speak to your doctor. They can advise on the best way to manage your blood pressure.


The Morning Blood Pressure Surge: Therapeutic Implications. J Clin Hypertens (Greenwich). February 2008 –

Morning blood pressure surge is associated with arterial stiffness and sympathetic baroreflex sensitivity in hypertensive seniors. American Journal of Physiology. September 2013 –

The morning blood pressure surge a dynamic and challenging concept. Journal of Hypertension. December 2011 –

Blood pressure: Does it have a daily pattern? Mayo Clinic. June 2022 –

High Blood Pressure–Understanding the Silent Killer. FDA. June 2021 –

Dietary fibre in hypertension and cardiovascular disease management: systematic review and meta-analyses. BMC Medicine. April 2022 –

Medically Reviewed

dr jay shah photo

Renowned cardiologist, physician leader, and angel investor.

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