Masked Hypertension in the Elderly: Cross-Sectional Analysis of a Population-Based Sample

In 2002, Dr Thomas Pickering and our group introduced the term masked hypertension (MHT) 1 to describe individuals with normal clinic blood pressure (CBP) levels (<140/90 mm Hg) and ambulatory hypertension (awake ≥135/85 mm Hg). MHT is associated with increased left ventricular (LV) mass, 2 a marker of cardiovascular end-organ damage, and an increased risk of cardiovascular disease (CVD) events, that is significantly more than in sustained normotension (clinic and ambulatory normotension). [3][4][5][6][7] The confluence of increased CVD risk, a failure to be diagnosed by the conventional approach of blood pressure measurement in the clinic setting, and relatively high prevalence 8-11 makes MHT a public health concern.Epidemiologic studies have shown that CBP in the prehypertension (PHT) range (i.e., mean systolic blood pressure (SBP) 120-139 mm Hg or mean diastolic blood pressure (DBP) 80-89 mm Hg) confer an increased CVD risk. 12 PHT is associated with higher levels of LV mass 13 and also a higher risk of CVD events, 12 compared to optimal blood pressure levels (<120/80 mm Hg).Recent evidence suggests that CBP levels are significantly higher among individuals with MHT compared to individuals with sustained normotension, 9 despite both groups having CBP levels in the normal range (<140/90 mm Hg). These findings suggest that the prevalence of PHT may be disproportionally higher in MHT than in sustained normotension, or alternatively that the prevalence of MHT may be higher in PHT than in those with optimal CBP. These hypotheses have not been directly examined in previous studies, particularly when out-of-office blood pressure is determined by an ambulatory blood pressure (ABP) monitoring. Furthermore, the relative contributions of MHT and PHT to CVD risk are also unclear. The primary aim of this study was to evaluate the BackgroundMasked hypertension (MHT) and prehypertension (PHT) are both associated with an increase in cardiovascular disease (CVD) risk, relative to sustained normotension. This study examined the diagnostic overlap between MHT and PHT, and their interrelationships with left ventricular (LV) mass index (LVMI), a marker of cardiovascular end-organ damage.

Section: Masked Hypertension and Prehypertensionmentioning

confidence: 99%

Masked hypertension and prehypertension: diagnostic overlap and interrelationships with left ventricular mass: the masked hypertension study

Shimbo

Newman

Schwartz

2012

“…17,18 The participants in the present study were part of the 3C-Study, which evaluated the risk of dementia attributable to vascular factors in a population-based cohort of the elderly. 17 To summarize, participants were randomly selected from the electoral rolls between 1999 and 2000.…”

Section: Study Samplementioning

confidence: 99%

Blood Pressure Variability in Elderly Persons With White-Coat and Masked Hypertension Compared to Those With Normotension and Sustained Hypertension

Cacciolati

Tzourio

Hanon

2012

Self Cite

BackgroundThe relationship between blood pressure (BP) measured, its variability, and risk of cardiovascular events is well established; however, it is not well known whether there is a difference of variability between the four categories of BP status obtained by the comparison of office and home BP measurements: normotension and masked, white-coat, and sustained hypertension. Here, we assessed BP variability (BPV) according to BP status in the elderly.

“…An older age, [3][4][5] male sex, [3][4][5][6] obesity, 4 and high-normal systolic OBP 3,5,6 have been proposed as determinants of masked hypertension in several previous studies. Masked hypertension is reported to be common in patients with type 2 diabetes without 7,8 or with 7,9 antihypertensive medication. Both diabetes and hypertension increase the risk of developing cardiovascular disease, and tight BP control is associated with a reduction in the risk of diabetes-related death and the risk of developing heart disease, stroke, or progression of retinopathy.…”

mentioning

confidence: 99%

High Sodium Intake Is Associated With Masked Hypertension in Japanese Patients With Type 2 Diabetes and Treated Hypertension

Uzu

Nakao

Kume

et al. 2012