This is all very interesting to me and helps explain a lot. I have been on numerous HBP drugs but currently on Avalide (ARB with diuretic) 300 mgs. in morning and Atenolol 50mg 2X a day. I have been experimenting taking the atenolol - first dose at 5 p.m. and second dose at 10 p.m. to see if that makes a difference in nocturnal hypertension. It's also interesting that you mentioned the pre diabetes thoery. My dad has had high blood pressure all his life life (he is now 80 yrs.) and just recently got it under control through a good cardiologist. He has borderline diabetes and it runs in my family. At last exam my blood test did not indicate diabetes but that is definitely food for thought. I am tracking my numbers very carefully to get a pattern before I see a cardiologist this month. What has been your experience with different drugs? I have a high resting pulse so beta blockers work for me best but atenolol at 100 mgs! My doctor mentioned a betablocker that lacks the negative side effects. Do you know what one that is? He said is more expensive. It sounds like you have your situation under control and I want to control this frustrating disease while I am still relatively young (mid forties). Thanks so much for your insight!

Beerzoids,

I have also had a frustrating time trying to find a combo of drugs that works, partly due to an unimformed doctor that I stayed with too long. Last week I went to a primary care clinic with an uncontrolled BP of 180/120 ! He put me on Avalide (ARB with diuretic) and atenolol. I had been on the atenolol before but found it dragged me down at high dosages. But at BP numbers this high, that's a small price to pay! Anyway, I've been taking the Avalide in the morning and then 50 mg. of Atenolol at 5 P.m and 25 mg. at 10:00 P.m. If I take more Atenolol than that at bedtime, my morning BP is too low and I feel light headed. I have been very happy to see my BP coming down...tonight it was 118/78 and my pulse was 87 (without atenolol my pulse easily runs 90-110 bpm.) I am just hoping that this combo continues to work! Hope that helps answer some of your questions. Overall, Atenolol is the best BP drug that I can possibly take, but the side effects suck! Avalide is probably contributing some too, but is very expensive!