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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

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Untreated masked hypertension and carotid atherosclerosis: a meta-analysis

Cesare Cuspidi1, Carla Sala, Marijana Tadic

  • 1Department of Health Science, University of Milano-Bicocca , Milan , Italy.

Blood Pressure
|January 23, 2015
PubMed

Insights

Masked hypertension (MH) is linked to increased carotid atherosclerosis risk. Early detection through carotid ultrasound may improve cardiovascular risk assessment in these patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Hypertension Research

Background:

  • Masked hypertension (MH) is a recognized clinical condition associated with poor cardiovascular outcomes.
  • Limited research has explored the impact of MH on subclinical vascular damage, particularly carotid atherosclerosis.
  • This meta-analysis focuses on evaluating the link between MH and early signs of carotid artery disease in untreated individuals.

Purpose of the Study:

  • To conduct a meta-analysis assessing the association between masked hypertension and subclinical carotid atherosclerosis.
  • To investigate whether MH is linked to increased carotid intima-media thickness (IMT) in untreated adults.
  • To determine the implications of MH for cardiovascular risk stratification.

Main Methods:

  • A systematic literature search was performed using keywords related to masked hypertension, carotid atherosclerosis, and intima-media thickness.
  • Included studies focused on untreated adult individuals and reported data on carotid IMT.
  • Five studies involving 2752 participants (normotensive, MH, and hypertensive) were included in the meta-analysis.

Main Results:

  • Common carotid intima-media thickness (IMT) progressively increased from normotensive to masked hypertensive and sustained hypertensive subjects.
  • A significant association was found between MH and increased carotid IMT compared to normotensive individuals (SMD: 0.51 ± 0.19, p < 0.01).
  • The difference between MH and normotension became borderline after adjusting for publication bias, with sensitivity analysis confirming robustness.

Conclusions:

  • Masked hypertension is associated with a higher risk of developing early carotid atherosclerosis compared to true normotension.
  • Ultrasound assessment of preclinical carotid disease in MH patients can enhance cardiovascular risk stratification.
  • These findings suggest improved clinical decision-making strategies for individuals with masked hypertension.
Abstract

Keywords:
Ambulatory blood pressure monitoringcarotid intima-media thicknesshome blood pressure monitoringmasked hypertension

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