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Untreated Masked Hypertension and Subclinical Cardiac Damage: A Systematic Review and Meta-analysis

Cesare Cuspidi1, Carla Sala2, Marijana Tadic3

  • 1Department of Health Science, University of Milano-Bicocca, Milano, Italy; Istituto Auxologico Italiano, Milano, Italy; cesare.cuspidi@unimib.it.

American Journal of Hypertension
|December 4, 2014
PubMed

Insights

Masked hypertension (MH), normal in-office but high out-of-office blood pressure, is linked to increased left ventricular structural alterations. Early screening for MH is crucial for detecting cardiac damage and guiding treatment to improve cardiovascular prognosis.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Masked hypertension (MH) is defined by normal office blood pressure and elevated out-of-office readings.
  • Subclinical cardiac damage associated with MH is not well-characterized.
  • Ambulatory blood pressure monitoring is key to identifying MH.

Purpose of the Study:

  • To conduct a meta-analysis assessing cardiac damage in individuals with masked hypertension.
  • To provide comprehensive data on subclinical cardiac alterations in MH patients.

Main Methods:

  • Systematic literature search for studies on masked hypertension and cardiac damage (left ventricular mass/hypertrophy).
  • Inclusion of 12 studies analyzing data from 4,884 untreated subjects.
  • Assessment of left ventricular mass index and hypertrophy prevalence using echocardiography.

Main Results:

  • Left ventricular mass index progressively increased from normotensive to MH and sustained hypertensive groups.
  • Significant differences in left ventricular mass index were observed between normotensive and MH individuals (P < 0.01).
  • Publication bias was assessed, and the significant differences between groups persisted.

Conclusions:

  • Masked hypertension is associated with a higher risk of left ventricular structural alterations compared to normotensive individuals.
  • Subclinical cardiac damage in MH suggests a worse cardiovascular prognosis.
  • Careful screening for MH is recommended to detect organ damage and initiate timely therapeutic interventions.
Abstract

Keywords:
ambulatory blood pressure monitoringblood pressurehypertensionleft ventricular hypertrophyleft ventricular massmasked hypertension.

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