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Prevalence and Cardio-Renal Comorbidities of Masked Hypertension: A Meta-Analysis
Hailan Zhu1, Jiahuan Li1, Lingxiao Li1
1Department of Cardiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
Insights
Masked hypertension is common, affecting 18% of adults. This condition significantly increases the risk of death, cardiovascular disease, and kidney problems.
Area of Science:
- Cardiology
- Nephrology
- Epidemiology
Background:
- Masked hypertension, characterized by normal blood pressure in clinical settings but elevated readings outside, has a controversial prognosis.
- Understanding its global prevalence and associated health risks is crucial for patient management.
Purpose of the Study:
- To determine the global prevalence of masked hypertension.
- To assess the association between masked hypertension and cardiorenal comorbidities and all-cause mortality.
Main Methods:
- A comprehensive meta-analysis was conducted, searching multiple databases up to January 15, 2024.
- Included were 26 cohort studies involving 129,061 participants with a median follow-up of 7.38 years.
Main Results:
- The pooled prevalence of masked hypertension was 18% (95% CI 15%-21%).
- Individuals with masked hypertension faced higher risks of all-cause mortality (RR 1.64) and incident cardiovascular disease (RR 1.57) compared to normotensive individuals.
- Significant associations were also found with cardiovascular mortality (RR 1.69) and composite renal outcomes (RR 3.57).
Conclusions:
- Masked hypertension is a prevalent condition in the adult population.
- It is significantly associated with increased risks of all-cause mortality, cardiovascular disease, cardiovascular mortality, and composite renal events.
Aim:
The prognosis of masked hypertension is controversial. The aims of this meta-analysis were to determine the global prevalence of masked hypertension and to better understand its association with the risk of cardiorenal comorbidities and all-cause mortality.
Methods:
We searched the PubMed, Embase (OVID), The Cochrane Library, WanFang Data, and CNKI databases for relevant studies published from inception until January 15, 2024. Cohort studies that reported an association of masked hypertension with the risk of cardiorenal comorbidities and all-cause mortality were eligible for meta-analysis.
Results:
Twenty-six studies (with 129,061 participants) were included. The median follow-up duration was 7.38 years. The pooled prevalence of masked hypertension was 18% (95% confidence interval [CI] 15%-21%). Compared with normotensive individuals, those with masked hypertension had an increased risk of all-cause mortality (relative risk [RR] 1.64, 95% CI 1.32-2.04) and incident cardiovascular disease (RR 1.57, 95% CI 1.45-1.69). The results were similar regardless of treatment status and in multiple subgroup analyses. Masked hypertension was also associated with increased risks of cardiovascular mortality (RR 1.69, 95% CI 1.02-2.78) and composite renal outcomes (RR 3.57, 95% CI 2.32-5.50).
Conclusion:
Masked hypertension is prevalent in adults and associated with increased risks of all-cause mortality, cardiovascular disease, cardiovascular mortality, and composite renal events.
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