Related Experiment Videos

Predictive factors for masked hypertension within a population of controlled hypertensives

Jean-Michel Mallion1, Pierre Clerson, Guillaume Bobrie

  • 1Service de Cardiologie et hypertension artérielle, CHU, Grenoble, Roubaix, HEGP, Paris, France. jmmallion@chu-grenoble.fr

Journal of Hypertension
|November 4, 2006
PubMed

Insights

Masked hypertension (MH), common in older adults, is linked to poor cardiovascular outcomes. Home blood pressure monitoring (HBPM) can detect MH in patients with controlled office blood pressure, especially those with elevated office systolic BP.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Masked hypertension (MH) affects up to 40% of patients and is associated with adverse cardiovascular prognosis.
  • Home blood pressure measurement (HBPM) is crucial for detecting MH, yet it is not routinely performed.
  • The SHEAF study highlighted the prognostic significance of MH detected via HBPM.

Purpose of the Study:

  • To define the clinical profile of masked hypertensives among treated hypertensive individuals with controlled office blood pressure (BP).
  • To identify factors associated with a higher prevalence of MH in this population.
  • To establish criteria for systematic HBPM to improve MH detection.

Main Methods:

  • A cohort of 1150 treated hypertensive patients over 60 with controlled office BP (SBP < 140 mmHg, DBP < 90 mmHg) underwent both clinic and home BP measurements.
  • Risk factors for MH were analyzed using statistical methods, including decision trees.
  • Home blood pressure measurement (HBPM) was performed by patients themselves.

Main Results:

  • 40% of patients (463/1150) were diagnosed with masked hypertension (MH) based on home BP readings (SBP ≥ 135 mmHg or DBP ≥ 85 mmHg).
  • Office systolic blood pressure (SBP), male gender, and older age were significantly associated with MH.
  • Decision tree analysis identified an office SBP threshold of 130 mmHg as efficient for proposing HBPM, with male gender and age over 70 being key factors in males.

Conclusions:

  • Selecting patients with office SBP between 130-140 mmHg for home blood pressure measurement (HBPM) is a logical strategy to detect masked hypertension (MH).
  • This targeted approach can improve the efficiency of MH screening in clinical practice.
  • Early detection of MH through HBPM can aid in risk stratification and management of hypertensive patients.
Abstract

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Factors affecting Blood pressure01:28

Factors affecting Blood pressure

Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...