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Masked hypertension in diabetes mellitus: a potential risk

Kazuo Eguchi1, Joji Ishikawa, Satoshi Hoshide

  • 1Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY 10032, USA. ke2126@columbia.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|August 4, 2007
PubMed

Insights

Masked hypertension (high blood pressure outside the clinic) is common in diabetics. This condition is linked to increased risks of brain and kidney damage, suggesting the need for regular blood pressure monitoring.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology

Background:

  • Masked hypertension (MHT) prevalence and clinical significance in diabetic patients are not well-documented.
  • MHT is defined as clinic blood pressure <140/90 mm Hg and daytime ambulatory blood pressure ≥135/85 mm Hg.
  • Diabetic individuals with normal clinic blood pressure may still have elevated readings outside the clinical setting.

Purpose of the Study:

  • To assess the association between MHT and end-organ damage in Japanese diabetic patients.
  • To determine the prevalence of MHT in a cohort of clinically normotensive diabetic individuals.
  • To evaluate microvascular and macrovascular complications, including silent cerebral infarcts (SCIs), left ventricular mass, and albuminuria.

Main Methods:

  • A study involving 81 Japanese diabetic patients with normal clinic blood pressure.
  • Classification of patients into MHT and normotensive groups based on clinic and 24-hour ambulatory blood pressure monitoring.
  • Evaluation of silent cerebral infarcts (SCIs), left ventricular mass index, and albuminuria as indicators of end-organ damage.

Main Results:

  • The prevalence of MHT was high, affecting 46.9% of the studied diabetic population.
  • Patients with MHT exhibited significantly higher rates of SCIs (2.5 vs 1.1) and albuminuria (39% vs 16%) compared to normotensive diabetics.
  • No significant difference in left ventricular mass index was observed between the MHT and normotensive groups.

Conclusions:

  • Masked hypertension is prevalent in Japanese diabetic patients and is associated with significant brain and kidney damage.
  • These findings highlight the clinical importance of out-of-office blood pressure monitoring in diabetic individuals.
  • Regular ambulatory blood pressure monitoring may be crucial for identifying MHT and preventing complications in diabetics with normal clinic BP readings.

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