Q: My systolic blood pressure is mildly elevated shortly after I wake up. Should I be worried?

A: Probably not. Most people have slightly higher blood pressure in the morning, usually as a result of the autonomic nervous system (which controls such processes as heartbeat and breathing rate) getting pumped up to start the day. If the elevation is mild and brief, nothing needs to be done about it. But recent studies suggest that an exaggerated morning “surge” of systolic blood pressure (top number up to about 160 mmHg to 180 mmHg) is an indicator for future stroke risk. Such a surge could be a sign that a patient has stiff, aging arteries or is experiencing age-related retention of sodium and fluid, which elevates morning blood volume and blood pressure. If your systolic pressure exceeds 140 mmHg, or the elevation lasts for hours rather than several minutes (wearing a 24-hour blood pressure monitor provided by your doctor could detect blood pressure elevation before awakening), your doctor probably will recommend that you reduce your salt intake and/or adjust your blood pressure medication.