Tom Pickering as a clinical scientist: masked hypertension

Masked hypertension has been 'unmasked' by the use of the out-of-office measurement of blood pressure, as home BP monitoring or ambulatory blood pressure monitoring has become available. The term masked hypertension could be used more widely than the original version of masked hypertension; morning hypertension, stress-induced hypertension, and nocturnal hypertension are all classified as subtypes of masked hypertension. Masked hypertension can also be seen in patients with diabetes, that could change clinical practice in diabetes. Masked hypertension is associated with cardiovascular events, but most of the outcome studies are on antihypertensive medications. Therefore, masked hypertension includes insufficient treatment of hypertension. In Dr Pickering's latest review of masked hypertension, prehypertension or high normal blood pressure was stressed as an associating factor with masked hypertension. The biggest theme in the field of hypertension is how we can detect masked hypertension. I present two interesting cases of possible masked hypertension in this commentary.