Masked Hypertension and Obesity in Renal Transplant Recipients

The diagnosis of arterial hypertension has traditionally been based on measurements of blood pressure (BP) in the clinic. However, home or ambulatory BP monitoring (ABPM) is reported to correlate better with target organ damage than clinic BP readings. The other potential advantage of out-of-clinic BP measurement is the detection of both white-coat hypertension (WCHT) and masked hypertension (MHT). Studies have suggested that MHT have an increased risk of cardiovascular disease (CVD). We aimed to investigate the prevalence of MHT and to evaluate risk factors by ABPM in our renal transplant recipients. One hundred twenty-ninety patients who were followed up in our nephrology clinic were included in the study. The prevalence of MHT was 17%. In logistic regression analysis, we investigated factors associated with MHT. In a model with age, sex, smoking, presence of Diabetes mellitus (DM) and blood glucose, estimated glomerular filtration rate (eGFR), donor type, body mass index, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), we found that WHR (r: 18.61, P: .007) and smoking (r: 2.79, P: .011) were related with MHT. MHT was related to target organ damage and cardiovascular disease. The diagnosis and treatment of MHT are important. These findings suggesting that patients with high WC and smokers should be investigated with ABPM to diagnose masked hypertension. This approach may reduce adverse cardiovascular outcomes after transplantation.