- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Risk factors (2)
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Symptoms (1)
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Causes (5)
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- Blood pressure: Does it have a daily pattern?
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Complications (1)
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Treatments and drugs (7)
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Lifestyle and home remedies (11)
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Alternative medicine (2)
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Question
Blood pressure: Does it have a daily pattern?
Does blood pressure have a daily pattern? I've noticed that my blood pressure is always lower in the morning than at night.
Answer
from Sheldon G. Sheps, M.D.
Blood pressure has a daily pattern. Blood pressure is normally lower at night while you're sleeping. Your blood pressure starts to rise a few hours before you wake up. Your blood pressure continues to rise during the day, usually peaking in the middle of the afternoon. Then in the late afternoon and evening, your blood pressure begins dropping again.
Having an abnormal blood pressure pattern, such as high blood pressure in the morning, can mean that you have a health problem. Potential problems include:
- Poorly controlled high blood pressure
- Sleep apnea
- Tumors of the adrenal gland
- Kidney disease
Risk factors for developing an abnormal blood pressure pattern include:
- Night-shift work
- Caffeine use
- Tobacco use
- Too much stress
- Taking blood pressure medications that don't last 24 hours
Your doctor can tell you if an abnormal daily blood pressure pattern may need treatment. He or she may recommend a 24-hour blood pressure monitoring test. The device used for this test measures your blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over a typical day and night.
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- Redon J, et al. Nocturnal blood pressure versus nondipping pattern: What do they mean? Hypertension. 2008;51:41.
- Cuspidi C, et al. Nocturnal non-dipping pattern in untreated hypertensives at different cardiovascular risk according to the 2003 ESH/ESC guidelines. Blood Pressure. 2006;15:37.
- Birkenhager AM, et al. Causes and consequences of a non-dipping blood pressure profile. Netherlands Journal of Medicine. 2007;65:127.
- Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 9, 2012.
- Kaplan NM, et al. Kaplan's Clinical Hypertension. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2010:20.
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