Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Uncontrolled high blood pressure can increase your risk for serious health problems like heart attack and stroke.

High blood pressure is a common condition. Millions of Americans suffer from it. Generally, high blood pressure develops over many years. Since there are usually no symptoms, you may not know that you have high blood pressure until you are diagnosed. Fortunately, there are treatment options.

Studies have demonstrated that blood pressure rises and falls at different times of the day.

In general, your blood pressure and heart rate will be lower while you sleep and will begin to rise when you get out of bed. This natural fluctuation is known as circadian rhythm.

Morning rises in blood pressure are normal. But for patients with hypertension, rapid surges in morning blood pressure can cause problems. Morning surges in blood pressure have been associated with increased incidence of heart attack and stroke.

1. Elliott WJ; Cyclic and Circadian Variations in Cardiac Events; Am Jour of Hypertension, 2001; 14:291S-295S

When your healthcare professional measures your blood pressure, he or she will tell you two numbers: systolic and diastolic blood pressure. As an example, you may be told that your blood pressure is 110 over 80. This means that your systolic blood pressure is 110 and your diastolic blood pressure is 80. So what does this mean?

Systolic Blood Pressure

Systolic blood pressure is the amount of pressure that blood exerts on arteries and vessels while the heart is beating. Systolic comes from the ancient Greek word “systole” which means “a drawing together or a contraction.” The normal range for systolic blood pressure is 90 – 120 mmHg in adults.Your systolic blood pressure measurement becomes more important as you age.

Diastolic Blood Pressure

Diastolic blood pressure is the pressure that is exerted on the walls of the various arteries around the body in between heart beats when the heart is relaxed. Diastolic comes from the ancient Greek word “diastole’ which means “a drawing apart.” Diastolic blood pressure represents the minimum blood pressure in the arteries. The normal range for diastolic blood pressure is between 60 – 80 mmHg in adults.

The importance of your systolic vs. your diastolic blood pressure largely depends on your age and your other health conditions. According to a recent study published in the Journal of General Internal Medicine, if you’re under the age of 50 a high diastolic blood pressure is a better predictor of early mortality than an elevated systolic blood pressure. The opposite is true if you’re over the age of 50 when a high systolic pressure becomes the best predictor of early death.1 This doesn’t mean that if you’re over the age of 50 a high diastolic blood pressure isn’t important anymore – it is. High diastolic blood pressure can also increase the risk of dying early, but it’s not the best predictor of future health problems and death.

Your blood pressure measurements must be taken in context with your overall health. If you’ve been diagnosed with diabetes or if you have suffered a stroke, the importance of your systolic blood pressure reading may be more important to you than your diastolic reading. For this reason, it is wise to discuss the components of your blood pressure (systolic vs. diastolic) with your healthcare provider to understand what each may mean specifically for you.

1.Taylor,B, Wilt,T et al;“Impact of Diastolic and Systolic Blood Pressure on Mortality: Implications for the Definition of ‘Normal’“; Journal of General Internal Medicine; July, 2011; vol 26 (7); pp 685-690

High blood pressure can have severe health consequences. The higher your blood pressure and the longer it goes uncontrolled, the more severe these consequences can be. High blood pressure is a risk factor for the following conditions, as well as others:

  • Heart attack

  • Stroke

Please consult with your healthcare provider for further information on the consequences of high blood pressure.

In addition to taking your blood pressure medication as directed, you can make the following changes to your lifestyle to help control your condition:

  • Eat healthy foods.

  • Reduce your intake of salt.

  • Maintain a healthy weight.

  • Increase your physical activity.

  • Limit the amount of alcohol.

  • Stop smoking.

  • Monitor your blood pressure.

Please consult with your healthcare provider for more information on changes to your lifestyle.

INDERAL® XL is a prescription medication. As with all prescription drugs, you should follow your healthcare provider’s suggestions and ask him/her if you have any questions. Here are some important tips for taking INDERAL® XL:

  • Take one capsule of INDERAL® XL daily. Do not take more than one capsule daily without your physician’s knowledge and direction. Take it at night—around 10 pm is recommended. You can take your daily capsule with food or on an empty stomach.

  • Do not stop taking INDERAL® XL without consulting with your physician first. Some patients who suddenly stop taking INDERAL® XL may be at increased risk of chest pain or heart attack. Your healthcare provider will let you know the safest way to gradually reduce the dose over a few weeks.

  • Let your healthcare provider and pharmacist know about all of the other medicines you are taking, including supplements and over the counter medicines, so that they can check for potential interactions between INDERAL® XL and your other medications.

  • Make sure your healthcare provider knows your medical history. INDERAL® XL is not recommended for patients who have been previously diagnosed with a certain type of arrhythmia or with bronchial asthma or COPD. Let your healthcare provider know if you have ever had problems taking propranolol, the major ingredient in INDERAL® XL.

  • Store your INDERAL® XL in a cool, dry place where it will be secure.

INDERAL® XL: A Different Blood Pressure Medicine

Healthcare providers have known for years that blood pressure and heart rate surge in the morning hours (6 am – 12 pm) as you wake up. Until recently, the effects of these surges in blood pressure were not clearly understood. Recent clinical studies have demonstrated that an increase in the risk of heart attack and stroke that also occurs in the morning hours.

Your healthcare provider has many options in terms of medication that he or she can prescribe to control your blood pressure. Most blood pressure medications are taken once daily. Most do not reach their peak effect during the morning (6 am – 12 pm) even when they are taken at night.

INDERAL® XL is designed to reach its peak effect in the early morning hours so that it can offset the rise in blood pressure at that time of day. When you take INDERAL® XL as directed every evening at bedtime — around 10 pm is recommended — you may get the maximum protection in the morning. And because INDERAL® XL is a timed-release medication, it will keep working for 24 hours to keep your blood pressure under control all day.*

To learn more about high blood pressure and the risks of early morning surges for heart attacks and strokes, speak to your healthcare provider about INDERAL® XL.

*Individual results may vary.