Well, this could be a counter effect of the medication i.e. the body’s compensatory mechanism of normalising an increased low BP (high dose medication) or could result from other few causes such as stress/ anxiety, low blood sugar, cardiac arrhythmias etc. I would suggest considering a review with your treating cardiologist to look into possible secondary issues and depending on the cause detected, a management plan can be initiated accordingly.
Hope this is helpful.
Thank you for your response it is very helpful. Often I wake during the night with both arms very numb so it hurts. My average BP is 125/70 HR50-60 during the day.
It was suggested by my hepatologist to divide the dosage to taking two 40mg ER twice daily but when I communicated this to my general practice doctor it was somehow not changed when her office called in the prescription though she thought this would be no problem. Just an error I'm sure.
I never had this problem with my previous medication (metoprolol and lisinopril) but the propranolol was thought to be a more fitting beta blocker to assist with the portal hypertension.
Is the 40mg ER twice daily worth a try? If so I will further pursue this route. Thank you very much for your time and everything you do to assist MedHelp!