Should high BP pm should be treated ?

[mariepi]

My BP  gets really high when I have a migraine over 180-190 + /80-100  to return to 120/80 when pain is gone. I have very few of those now . For 15 years I have chronic pain, I was dx'ed with fibromyalgia 10 years ago, for me it is chronic pain, arthritis, hip bursitis, had hemi thyroidectomy, chronic back pain since childhood .
My gp ask me to take my BP twice a day because it is always high when I see him, his nurse does not take the BP according technique we read on the subject, so it is always high. My morning average with my machine is 131/69  pulse 68   Evening; 156/78 pulse75 at the end of the day the pain is all over my body. I take opiates long acting that permits me to be fairly active. I try to power walk at least 30 min. if not too much in pain every day if in pain every second  day. Since chronic pain I am not as active as before sport wise I used to be very active. I am sure that the raise of BP is caused by pain and age. I am 70 and overweight because of lack of exercises. My dr. wants to put on medication for high BP for few years .I will ask for a 24 hours telemetry  before but should I take meds at this time ?

[mariepi]

When I went back to my physician he said that I had "white coat Hyper BP" I am surprised because I am not anxious when I see him. I will not take meds for now except the clonidine .1 mg when I plan to go out because I still have hot flashes and flushes with hyperhidrosis and intolerance to heat.
Summer is coming not even normal spring but already have these.
I will take my BP twice a week and the next time I see him it will be discussed.
What bothers me is the difference between morning and evening. I try to walk  as much as I can if I am not in severe pain, power walks with Nordic poles but the wind the sun even with protection and the exercise are triggers to facial and upper neck flushes and sweating as a horse after a run, I need to walk if not I become depressed and not very nice.

[mariepi]

"You can try lifestyle changes like don't add additional salt in your diet, exercise regularly and practice relaxation techniques to lower your stress level"

I already do all these as I my husband is treated for heart disease for many years, his is a family thing, he is under medication and doing well.  What I discovered in taking my BP twice a day is that morning before coffee is around -134/-70 and evening +145/+80.
The difference between morning and evening should be of what ?

[Paderla Anitha, DNB]

Hi, I assume you are not on any medications now. Pain tends to increase the blood pressure. Also, there is an entity called White coat hypertension, more commonly known as white coat syndrome, is a phenomenon in which patients exhibit elevated blood pressure in a clinical setting. You can consider the values you record as the baseline values. The recommended goal for systolic pressure is less than 140 mm Hg. You can try lifestyle changes like don't add additional salt in your diet, exercise regularly and practice relaxation techniques to lower your stress levels. And see if this helps. If the value is till raised then you can opt for medications. Regards.