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Masked hypertension and prehypertension: diagnostic overlap and interrelationships with left ventricular mass: the

Daichi Shimbo1, Jonathan D Newman, Joseph E Schwartz

  • 1Department of Medicine, Columbia University Medical Center, New York, New York, USA. ds2231@columbia.edu

American Journal of Hypertension
|March 2, 2012
PubMed

Insights

Masked hypertension and prehypertension significantly overlap and are linked to increased cardiovascular risk. Ambulatory blood pressure monitoring may not be necessary for individuals with optimal clinic blood pressure.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Diagnostics

Background:

  • Masked hypertension (MHT) and prehypertension (PHT) increase cardiovascular disease (CVD) risk compared to normotension.
  • Understanding the overlap between MHT and PHT is crucial for assessing CVD risk.
  • Left ventricular mass index (LVMI) is a key indicator of cardiovascular end-organ damage.

Purpose of the Study:

  • To investigate the diagnostic overlap between masked hypertension and prehypertension.
  • To examine the relationship between MHT, PHT, and left ventricular mass index (LVMI).

Main Methods:

  • 813 participants without treated hypertension underwent clinic blood pressure (CBP) and 24-hour ambulatory blood pressure (ABP) monitoring.
  • Left ventricular mass index (LVMI) was assessed via echocardiography in 784 participants.
  • Data analysis adjusted for multiple cardiovascular risk factors.

Main Results:

  • A significant overlap was observed: 83.8% of MHT participants also had PHT, and 34.1% of PHT participants had MHT.
  • MHT was rare (3.9%) in individuals with optimal CBP (<120/80 mm Hg).
  • Elevated LVMI was associated with both PHT without MHT and PHT with MHT, compared to optimal CBP with MHT.

Conclusions:

  • Substantial diagnostic overlap exists between masked hypertension and prehypertension in a community sample.
  • Ambulatory blood pressure monitoring may not be clinically indicated for individuals with optimal clinic blood pressure readings.
  • Further research is needed to refine diagnostic strategies for hypertension subtypes.
Abstract

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