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Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

A S Konstantopoulou1, P S Konstantopoulou, I K Papargyriou

  • 11st Department of Propaedeutic Medicine, Athens University Medical School, Laiko General Hospital, Athens, Greece.

Journal of Human Hypertension
|July 3, 2009
PubMed

Insights

Masked hypertension, characterized by normal clinic and high out-of-clinic blood pressure (BP), presents intermediate cardiovascular risk. These patients exhibit distinct psychometric profiles compared to other hypertensive groups.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Masked hypertension (MH) is defined by normal clinic blood pressure (BP) and elevated out-of-clinic BP.
  • MH poses a significant cardiovascular risk, often underestimated due to normal office readings.
  • Understanding the cardiovascular and psychometric status of MH is crucial for risk stratification.

Purpose of the Study:

  • To compare the cardiovascular status and psychometric characteristics of patients with masked hypertension (MH) versus white coat hypertension (WCH) and sustained hypertension (SH).
  • To evaluate cardiovascular risk, morbidity, and renal disease in MH compared to WCH and SH.
  • To analyze the psychological profile, including personality and mood, of individuals with MH.

Main Methods:

  • Comparative study involving three groups: masked (n=100), white coat (n=100), and sustained hypertension (n=100).
  • Diagnosis confirmed using ambulatory BP monitoring.
  • Assessment included left ventricular hypertrophy indexes, estimated total cardiovascular risk, cardiovascular morbidity, renal disease, and psychometric evaluations (Type-A personality, mood behavior).

Main Results:

  • Masked hypertensives exhibited intermediate left ventricular hypertrophy indexes and total cardiovascular risk compared to WCH and SH.
  • Cardiovascular morbidity and renal disease in MH were higher than in WCH and similar to SH.
  • MH patients had higher education, exercised more, received fewer medications, and displayed different personality/mood profiles (lower Type-A, hypomania-euthymia range) than WCH and SH.

Conclusions:

  • Masked hypertension is associated with a higher cardiovascular risk than white coat hypertension and a risk similar to sustained hypertension.
  • Individuals with MH possess distinct demographic, lifestyle, and psychometric characteristics.
  • Ambulatory BP monitoring is essential for identifying MH and guiding appropriate cardiovascular risk management.

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