Masked Hypertension and Target Organ Damage in Treated Hypertensive Patients

Tomiyama, Mari; Horio, Takeshi; Yoshii, Masayoshi; Takiuchi, Shin; Kamide, Kei; Nakamura, Satoko; Yoshihara, Fumiki; Nakahama, Hajime; Inenaga, Takashi; Kawano, Yuhei

doi:10.1016/j.amjhyper.2006.03.006

Cited by 89 publications

(56 citation statements)

References 24 publications

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“…Nocturnal dipping was larger in white coat hypertensives opposed to earlier studies 25 and was similar in masked and sustained hypertensives. 26 The first morning BP readings were higher in the MH than in the WCH group and comparable to the SH group, adding another risk factor related to target organ damage and cardiovascular morbidity. 27 In line with earlier reports, MH was related to physical training, higher educational level and higher sense of responsibilities at work than at home, which can be regarded as greater reactivity to daily stressors that might increase daytime BP.…”

Section: Discussionmentioning

confidence: 84%

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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Masked hypertension is defined as low clinic and elevated out-of-clinic pressure (blood pressure, BP) assessed either by patients at home or by ambulatory monitoring. This study compared the cardiovascular status and psychometric characteristics of masked, white coat and sustained hypertensives. Three groups of consecutive subjects with masked (n ¼ 100, age 59 ± 11 years), white coat (n ¼ 100, 60 ± 10 years) and sustained hypertension (n ¼ 100, 60 ± 11 years) diagnosed by ambulatory BP monitoring were compared. Masked hypertensives had higher educational level, exercised more frequently, received fewer drugs and sensed more responsibilities at work than at home. Their left ventricular hypertrophy indexes fall inbetween those with white coat and sustained, the latter having the highest values. The estimated total cardiovascular risk was intermediate between white coat and sustained, whereas their cardiovascular morbidity and renal disease was higher than that of white coat and similar to sustained. Psychological profile analysis showed lower score for type-A personality and their mood behaviour in the hypomania-euthymia range compared with white coat and sustained hypertensives. The cardiovascular risk of masked hypertensives is higher than that of white coat and similar to sustained. Masked hypertensives have higher educational level, better physical training and different personality/mood pattern than white coat and sustained.

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Section: Discussionmentioning

confidence: 84%

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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“…24 In addition, our recent study showed that masked hypertension was associated with advanced target organ damage in treated hypertensive patients, comparable to that in cases of sustained hypertension. 25 Furthermore, prospective studies have revealed that a high ambulatory or home BP is a powerful predictor for cardiovascular morbidity and mortality in the general population and treated hypertensive patients even when their office BP is normal or well controlled. 10,11,[26][27][28] As for the association between LV geometry and cardiovascular prognosis, it was reported that hypertensive patients with concentric hypertrophy among four LV geometric patterns had the highest incidence of cardiovascular events and death.…”

Section: Discussionmentioning

confidence: 99%

Reverse white-coat effect as an independent risk for left ventricular concentric hypertrophy in patients with treated essential hypertension

et al. 2006

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Recent studies have shown that the converse phenomenon of white-coat hypertension called 'reverse white-coat hypertension' or 'masked hypertension' is associated with poor cardiovascular prognosis. We assessed the hypothesis that this phenomenon may specifically influence left ventricular (LV) structure in treated hypertensive patients. A total of 272 outpatients (mean age, 65 years) with chronically treated essential hypertension and without remarkable white-coat effect were enrolled. Patients were classified into two groups according to office and daytime ambulatory systolic blood pressure (SBP); that is subjects without (Group 1: office SBP Xdaytime SBP, n ¼ 149) and with reverse white-coat effect (Group 2: office SBPodaytime SBP, n ¼ 123). LV mass index and relative wall thickness were echocardiographically determined. In all subjects, LV mass index and relative wall thickness were positively correlated with daytime and 24-h SBP, but not with office SBP. In addition, these two indices were inversely correlated with office -daytime SBP difference. LV mass index (136731 and 115728 g/m 2 , mean7s.d.) and relative wall thickness (0.4970.09 and 0.4670.07) were significantly greater in Group 2 than in Group 1. As for LV geometric patterns, Group 2 had a significantly higher rate of concentric hypertrophy compared with Group 1 (48 and 28%). Multivariate analyses revealed that the presence of reverse white-coat effect was a predictor for LV concentric hypertrophy, independent of age, sex, hypertension duration, antihypertensive treatment and ambulatory blood pressure levels. Our findings demonstrate that reverse white-coat effect is an independent risk factor for LV hypertrophy, especially concentric hypertrophy, in treated hypertensive patients.

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“…Left ventricular mass index, carotid maximal intimamedia thickness, and urinary albumin level were higher in persons with masked hypertension than in persons with controlled hypertension and similar to those with sustained hypertension (7). A meta-analysis of seven studies including 11,502 persons, mean age 63 years, showed at 8.0-year follow-up that compared to normotensive persons, persons with masked hypertension had a 2.0 times increase in first cardiovascular events, and persons with sustained hypertension had a 2.28 times increase in first cardiovascular events (8).…”

mentioning

confidence: 96%

“…Masked hypertension was diagnosed by ambulatory blood pressure monitoring in 14% of persons and by home blood pressure monitoring by 11% of persons (6). It may be reasonable to screen for masked hypertension with ambulatory blood pressure monitoring or with home blood pressure monitoring if the office systolic blood pressure is 120 to 129 mmHg or if the office diastolic blood pressure is 75 to 79 mmHg (6)(7)(8)(9)(10).…”

mentioning

confidence: 99%