Thank you, Doctor.
I’m 61, see my doctor regularly (most recently two months ago), am on no medication, exercise regularly, don't smoke or drink to excess and am in excellent physical condition. I do have a history of borderline/labile blood pressure readings and my most recent 24-hour ambulatory blood pressure/ Holter monitor average was 138/78, with overnight (sleep) readings dropping as low as 108/64. During the day I get a range of readings from 118/68 (evenings) - 160/76 (some midmornings) and have lately noticed a more consistent elevated morning pattern which I’d like to ask you about.
When I first awaken in the morning, my readings are from 130/70 to 140/74, with occasional ones of 124/68 in there as well. Following periods of rather intense/analytical morning computer work, my blood pressure rises to levels of 150/76 to 160/78 and, now and then, it will remain there for 30-60 minutes (and sometimes will be at 150 for as long as 2 hours) after the computer work has completely stopped and I sit quietly at my desk reading and relaxing (I work from home so it's easy for me to take repeated readings while resting at my desk; I'm also certain that I become anxious about those elevated readings, which likely causes them to remain elevated longer than they would otherwise.
My blood pressure then tends to settle after that initial morning period of elevation and will subsequently be between 130/76 - 138/74 for the rest of the morning and afternoon, with several readings also in the 125/73 range (my diastolics are always fine) and with others from 136/76 - 140/72 throughout the day.
In the evenings, while I will sometimes record lower results of 115/70 - 125/72, I can typically depend on evening readings of 126/76 -134/74, with occasional quite-low ones of 112/70 (but that’s less common, perhaps once every week or so).
So, Doctor, it’s those fairly regular early-morning and mid-morning periods of elevated readings from 150/78 - 160/78 (i.e., those elevated readings don't happen every morning but likely a few days per week) , which last from 30 minutes to a maximum of a couple of hours of 150/78, before dropping to normal levels, that have me wondering whether I should be concerned or considering medication. On the positive side, it’s apparent from the ambulatory results that my overnight readings do drop nicely to the 108 area so I know that my blood pressure is not chronically or consistently high and I also know that, often during the day and on many midmornings, the readings are in the 122/78-136/74 areas, with near-daily, lower results of 119/68 - 125/70 also reported.
There’s no question that I’m sometimes getting a bit intense as I work on these computer issues and that, when I do see a couple of higher readings, I become anxious about them and thus prevent their quicker dropping.
Please let me know your overall assessment.