Friday, June 02, 2023

Masked hypertension

The introduction of ambulatory blood pressure (ABP) monitoring has led to the identification of four patterns of blood pressure (BP) phenotypes, i.e. sustained normotension (NT), sustained hypertension (SHT), white coat hypertension (WCHT) and masked hypertension (MHT).

Masked hypertension is defined as a normal blood pressure (BP) in the clinic or office (<140/90 mmHg), but an elevated BP out of the clinic (ambulatory daytime BP or home BP>135/85 mmHg).

Masked hypertension is a commonly overlooked phenotype of hypertension in practice. Lifestyle factors and conditioned stress response specific to out of clinic blood pressure readings may be the mechanisms leading to this phenomenon.

Masked hypertension is estimated to occur in 10% to 30% of the general population and is important because it is not diagnosed by routine medical examinations, but carries an adverse prognosis, both in terms of increased target organ damage and cardiovascular events.

Masked hypertension is associated with high cardiovascular risk, is common in both untreated and treated subjects, and can be identified by home or ambulatory BP monitoring (ABPM).

Possible characteristics of individuals with masked hypertension are: relatively young age, male sex, stress or increased physical activity during the daytime, and smoking or drinking habits.

The prevalence of masked hypertension was high in patients of African descent; sub-Saharan Africans up to 18% and African Americans up to 52.25%, whereas it was low in Korean (5.7%) and Omani (6%) populations.
Masked hypertension

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