Abnormal blood pressure readings

[Astrenos]

I am a 75 year old male in good physical health, good weight, doing regular exercise.  About two and a half months ago, I took my blood pressure and discovered it was 195/85.  I went to the doctor and he has been gradually increasing my medication.  It is now 100 mg. of Metoprolol twice a day and 5 mg. of Amlodipine Vesylata twice a day.  My blood pressure has consistently been very high at night, rather high in the morning, and low in the middle of the day which I understand is not normal.  It had come down, e.g.

160/78, pulse 40 at 10:00 a.m.
121/68, pulse 68 at 3:00 p.m.
170/77, pulse 43 at 11:00 p.m.

However, my feet were swollen, so one day only I took a half dose.  Since then, about a week ago, it has remained high at night.

151/78, pulse 41 at 10:00 a.m.
115/57, pulse 48 at 3:00 p.m.
194/95, pulse 50 at 11:00 p.m.

I have always had a low pulse.
Questions: What does the spike in the P.M. mean?
                 Why does the spike happen?
                 Should I be worried?

Thank you for answering.  This is a valuable service.  You help to calm worried people and get those who should go, to the doctor.

Artemis

[Astrenos]

Thanks for your consideration and advice.  Ed34, no, the 10:00 blood pressure reading is before I eat.  The monitor is new (about two months old!) so, I imagine it is accurate.  Your explanation of the variation in readings was interesting and useful.  

Mammo, thank you also.  I was told by the doctor's assistant that perhaps I should have my kidneys checked.  Now, with your encouragement, I will.

Artemis

[mammo]

Today, most of your at home monitors are very accurate.  Your pulse is too low at times, and  your blood pressure too high.  Although our BP does fluctuate througout the day, it should remain within a certain range.  Obviously, your BP meds are not working, for you BP to be spiking, and you need to find out why.  Have you have your kidneys checked?  If one or both of your kidneys aren't functioning at a 100%, it will raise you BP.  I would take what you have on your BP readings and go back to you doctor. It may be that he will want to incerease your meds, or have you take them differently, but he needs to find out what is causing the spiking to be so high.  BP normally doesn't "spike" like this, it will go up and down, but your's is getting dangerously high.  Better to see your doctor regarding this.

[ed34]

As we age, our blood pressure does increase, obviously the arteries are not as flexible as they used to be. Monitoring your blood pressure is not quite so straight forward, it
depends on what activities you have done, or have not done.
For example, when you say 10am I assume you have had your breakfast first. When
you eat, your blood pressure will rise because the digestive system puts more demand
on the heart. The digestive system is a heavy processing factory. Try taking your morning pulse as soon as you get out of bed. I could be wrong, maybe you have a
lay in every day?
At 3.00pm your lunch should have passed through the heavy part of the digestive system
so allowing your pressure to relax. But, as the day progresses you would expect your
blood pressure to creep up. At bedtime your blood pressure is far too high. Have you
had a big snack to sleep on? I would ask your gp about your evening bp.
Also, try to callibrate your monitor. Take it along to your gp, take your bp using it and
then get the doctor to check your bp with a stethascope and cuff. See if there is much
difference, I bet there is.