Masked hypertension definition, impact, outcomes: a critical review

Dimitris P Papadopoulos1, Thomas K Makris

  • 1Hypertension Clinic, Cardiology Department, Laiko Hospital, Athens, Greece. jimpapdoc@yahoo.com

Insights

Masked hypertension (MH), where out-of-office blood pressure is high but office readings are normal, affects 1 in 7-8 people. This condition increases cardiovascular risk, necessitating out-of-office BP monitoring.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Masked hypertension (MH) is characterized by normal office blood pressure (<140/90 mm Hg) but elevated out-of-office readings.
  • MH affects approximately 1 in 7 to 8 individuals with seemingly normal or controlled office blood pressure.
  • Its prevalence is comparable to isolated office hypertension, highlighting a significant unmet clinical need.

Purpose of the Study:

  • To define masked hypertension (MH).
  • To describe the prevalence of MH in the general population.
  • To explore the association between MH and cardiovascular events.

Main Methods:

  • Literature review of studies defining MH and its prevalence.
  • Analysis of factors influencing MH, including stress and lifestyle.
  • Examination of outcome studies correlating MH with cardiovascular complications.

Main Results:

  • Individuals with MH exhibit increased prevalence of organ damage, including metabolic risk factors, left ventricular mass, and carotid intima-media thickness.
  • MH is associated with a cardiovascular risk comparable to sustained office and out-of-office hypertension.
  • Behavioral factors like smoking, alcohol, and sedentary habits can influence MH development.

Conclusions:

  • The high prevalence of MH underscores the importance of out-of-office blood pressure measurement.
  • MH is a significant risk factor for cardiovascular complications, similar to sustained hypertension.
  • Screening for MH is crucial in individuals at high risk for cardiovascular disease, such as those with kidney disease or diabetes.

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