Understanding Morning High Blood Pressure Despite Medication - Expert Advice

Question
Dear Doctor,
Why is it that my blood pressure is always high after waking up in the AM despite the medications I am taking. It is 160/70 when I wake up daily.My pressure goes down to 130/60 at the middle of the day and will rise again before bedtime but not as high in the AM. I am 78 year old female. Your response will be deeply appreciated. My meds are Diovan 320, Cartia 180, water pill 10mg. Norvasc 5mg and 0.01 clonidine in the evening. My pressure remains stubborn.            Thank you
                       Antonia Vivar
Please disregard this letter if I will have to pay as I am a senior trying to cut all edges.

Answer
Dear Antonia,   You are on a HIGH doseage of Diovan at 320...  I too take Diovan, but my doseage is only 80 and it controls my high blood pressure (before Diovan 220/110), and the Cartia is a calcium channel blocker and that is a mid range doseage, the water pill is often ordered because people with a heart condition and high blood pressure tend to cause fluid retention,and the Norvasc is ALSO for high blood pressure and angina (chest pain).....   I can't tell you why your blood pressure is high in the morning unless it is because all of this medication has worn off through the day and into the evening....  You sound like you have either a serious heart condition causing your high blood pressure or your doctor (if not a heart doctor then get one) can't get your blood pressure regulated/managed....  

You need to let your doctor know about the AM blood pressure and if you DO have a heart condition or blocked arteries, you need to be sent to a Cardiologist for more proper care and diagnosis....

thank you,   karen