Prevalence of Masked Hypertension Among US Adults With Nonelevated Clinic Blood Pressure

Abstract

Masked hypertension (MHT), defined as nonelevated blood pressure (BP) in the clinic setting and elevated BP assessed by ambulatory monitoring, is associated with increased risk of target organ damage, cardiovascular disease, and mortality. Currently, no estimate of MHT prevalence exists for the general US population. After pooling data from the Masked Hypertension Study (n = 811), a cross-sectional clinical investigation of systematic differences between clinic BP and ambulatory BP (ABP) in a community sample of employed adults in the New York City metropolitan area (2005-2012), and the National Health and Nutrition Examination Survey (NHANES; 2005-2010; n = 9,316), an ongoing nationally representative US survey, we used multiple imputation to impute ABP-defined hypertension status for NHANES participants and estimate MHT prevalence among the 139 million US adults with nonelevated clinic BP, no history of overt cardiovascular disease, and no use of antihypertensive medication. The estimated US prevalence of MHT in 2005-2010 was 12.3% of the adult population (95% confidence interval: 10.0, 14.5)-approximately 17.1 million persons aged ≥21 years. Consistent with prior research, estimated MHT prevalence was higher among older persons, males, and those with prehypertension or diabetes. To our knowledge, this study provides the first estimate of US MHT prevalence-nearly 1 in 8 adults with nonelevated clinic BP-and suggests that millions of US adults may be misclassified as not having hypertension.

Genetics of Hypertension

“…The mean waist circumference was also 6 points higher than in the other groups, possibly alluding to a correlation between higher weight and masked hypertension (Unsal et al, 2016). A study conducted by Wang et al (2017) tells us that the prevalence of masked hypertension is quite astounding, approximately 1 in 8 adults. This statistic is surely a contributing factor in terms of receiving effective treatment for patients with this condition as they are oftentimes misdiagnosed as non-hypertensive .…”

Evaluation of the Accuracy of a New Cuffless Magnetoplethysmography Blood Pressure Monitor in Hypertensive Patients

“…Because of this, BP measured during a narrow time window at the doctor's office, or in the clinic or hospital, is not regarded as a concrete standard [6,7,8]. Ambulatory and home BP monitoring [9,10,11] provide a more complete picture of an individual's BP range, and such measurements are actively used in clinical settings for diagnosis and treatment. Ambulatory and home BP monitoring are especially recommended for patients suspected to suffer from white-coat hypertension or masked hypertension [12,13].…”

Masked hypertension

“…Masked uncontrolled hypertension was associated with male gender, longer duration of hypertension, obesity, smoking, and diabetes mellitus (17). Using data from 9,316 persons in the National Health and Nutrition Examination Survey 2005-2010, the estimated prevalence of masked hypertension in the United States was 12.3% of adults (18). Masked hypertension was higher in older persons, men, diabetics, and those with prehypertension (18).…”

“…Using data from 9,316 persons in the National Health and Nutrition Examination Survey 2005-2010, the estimated prevalence of masked hypertension in the United States was 12.3% of adults (18). Masked hypertension was higher in older persons, men, diabetics, and those with prehypertension (18).…”