Masked Hypertension: An Independent Cardiovascular Risk Factor or a Facet of True Blood Pressure Level?

Jula, Antti

doi:10.1161/jaha.116.003415

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…Some recent studies have questioned this heightened risk with white-coat HTN and suggest that it may not be higher than their normotensive control subjects after adjustment of other risk factors [41][42][43] . In addition, masked HTN has been associated with increased CVD risk factors [43][44][45] . Most of these studies have been conducted in European and Asian populations 32 .…”

Section: Discussionmentioning

confidence: 99%

Twenty-four-hour versus clinic blood pressure levels as predictors of long-term cardiovascular and renal disease outcomes among African Americans

Kidambi

Wang

Chelius

et al. 2020

Sci Rep

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In Caucasian and Asian populations, evidence suggests that 24-h blood pressures (BP) are more predictive of long-term cardiovascular events than clinic BP. However, few long-term studies have evaluated the predictive value of 24-h BP phenotypes (24-h, daytime, nighttime) among African Americans (AA). The purpose of this study is to evaluate the added value of 24-h BP phenotypes compared to clinic BP in predicting the subsequent fatal and non-fatal cardiovascular/renal disease events in AA subjects. AA subjects (n = 270) were initially studied between 1994 and 2006 and standardized clinic BP measurements were obtained during screening procedures for a 3-day inpatient clinical study during which 24-h BP measurements were obtained. To assess the subsequent incidence of cardiovascular and renal disease events, follow-up information was obtained and confirmed by review of paper and electronic medical records between 2015 and 2017. During a mean follow-up of 14 ± 4 years, 50 subjects had one or more fatal or non-fatal cardiovascular/renal disease events. After adjustment for covariates, clinic systolic and diastolic BP were strongly associated with cardiovascular/renal disease events and all-cause mortality (p < 0.0001). Twenty-four-hour BP phenotypes conferred a small incremental advantage over clinic BP in predicting cardiovascular/renal events, which was limited to making a difference of one predicted event in 250-1,000 predictions depending on the 24-h BP phenotype. Nocturnal BP was no more predictive than the other 24-h BP phenotypes. In AA, 24-h BP monitoring provides limited added value as a predictor of cardiovascular/ renal disease events. Larger studies are needed in AA to confirm these findings.

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