Masked hypertension and prehypertension: diagnostic overlap and interrelationships with left ventricular mass: the masked hypertension study
Open Access
- 1 June 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Hypertension
- Vol. 25 (6), 664-671
- https://doi.org/10.1038/ajh.2012.15
Abstract
BackgroundMasked hypertension (MHT) and prehypertension (PHT) are both associated with an increase in cardiovascular disease (CVD) risk, relative to sustained normotension. This study examined the diagnostic overlap between MHT and PHT, and their interrelationships with left ventricular (LV) mass index (LVMI), a marker of cardiovascular end-organ damage.MethodsA research nurse performed three manual clinic blood pressure (CBP) measurements on three occasions over a 3-week period (total of nine readings, which were averaged) in 813 participants without treated hypertension from the Masked Hypertension Study, an ongoing worksite-based, population study. Twenty-four-hour ambulatory blood pressure (ABP) was assessed by using a SpaceLabs 90207 monitor. LVMI was determined by echocardiography in 784 (96.4%) participants.ResultsOf the 813 participants, 769 (94.6%) had normal CBP levels (<140/90 mm Hg). One hundred and seventeen (15.2%) participants with normal CBP had MHT (normal CBP and mean awake ABP ≥135/85 mm Hg) and 287 (37.3%) had PHT (mean CBP 120–139/80–89 mm Hg). 83.8% of MHT participants had PHT and 34.1% of PHT participants had MHT. MHT was infrequent (3.9%) when CBP was optimal (<120/80 mm Hg). After adjusting for age, gender, body mass index (BMI), race/ethnicity, history of high cholesterol, history of diabetes, current smoking, family history of hypertension, and physical activity, compared with optimal CBP with MHT participants, LVMI was significantly greater in PHT without MHT participants and in PHT with MHT participants.ConclusionsIn this community sample, there was substantial diagnostic overlap between MHT and PHT. The diagnosis of MHT using an ABP monitor may not be warranted for individuals with optimal CBP.Keywords
This publication has 33 references indexed in Scilit:
- Prevalence and Clinical Significance of Isolated Ambulatory Hypertension in Young Subjects Screened for Stage 1 HypertensionHypertension, 2004
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureThe JNC 7 ReportJAMA, 2003
- Isolated Ambulatory Hypertension Predicts Cardiovascular Morbidity in Elderly MenCirculation, 2003
- Masked HypertensionHypertension, 2002
- Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressureBMJ, 2002
- Reliability of ambulatory blood pressure monitoringBlood Pressure Monitoring, 2001
- Impact of High-Normal Blood Pressure on the Risk of Cardiovascular DiseaseThe New England Journal of Medicine, 2001
- Alterations of Cardiac Structure in Patients With Isolated Office, Ambulatory, or Home HypertensionCirculation, 2001
- White coat hypertension and white coat effect similarities and differences*American Journal of Hypertension, 1995
- Situational Variations of Blood Pressure in Ambulatory Hypertensive PatientsPsychosomatic Medicine, 1982