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Masked Hypertension: How to Identify and When to Treat?

Damiano Rizzoni1,2

  • 1Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina Spedali Civili di Brescia, Piazza Spedali Civili 1, 25100, Brescia, Italy. damiano.rizzoni@unibs.it.

High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension
|April 5, 2016
PubMed

Insights

Masked hypertension, where clinic blood pressure is normal but ambulatory blood pressure is high, increases cardiovascular risk. Current guidelines suggest considering lifestyle changes and medication for this condition.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Masked hypertension affects 1 in 7-8 individuals with normal clinic blood pressure (BP) and one-third of chronic kidney disease patients with normal clinic BP.
  • Patients with masked hypertension exhibit increased risks for target organ damage and cardiovascular events compared to those with normal BP in both settings.
  • Exclusion of masked hypertension patients from clinical trials due to normal clinic BP has left treatment efficacy unaddressed.

Purpose of the Study:

  • To highlight the increased cardiovascular risk associated with masked hypertension.
  • To address the knowledge gap regarding the benefits of hypertension treatment in masked hypertension patients.
  • To inform current management strategies for masked hypertension.

Main Methods:

  • Observational analysis of prevalence and risk factors for masked hypertension.
  • Review of existing literature on cardiovascular outcomes in masked hypertension.
  • Evaluation of current European guidelines regarding masked hypertension management.

Main Results:

  • Masked hypertension is associated with a two-fold increased risk of cardiovascular events.
  • Elevated ambulatory BP in the presence of normal clinic BP signifies significant cardiovascular risk.
  • Lack of interventional trial data for masked hypertension treatment efficacy.

Conclusions:

  • Masked hypertension poses a significant, under-recognized cardiovascular risk.
  • While awaiting interventional study results, current European guidelines recommend lifestyle modifications and pharmacotherapy for masked hypertension.
  • Further research is crucial to establish evidence-based treatment protocols for masked hypertension.

Keywords:
Ambulatory blood pressure monitoringHome blood pressureHypertensionMasked hypertensionTreatment

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