Document Detail

Detection of masked hypertension and the 'mask effect' in patients with well-controlled office blood pressure.
MedLine Citation:
PMID:  21048328     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Masked hypertension (MH) is characterized by its hidden nature and poor prognosis. However, it is not practical to routinely recommend home or ambulatory blood pressure monitoring (HBP or AMBP) to all patients with apparently well-controlled BP. The purpose of this study is to present, within the group of patients with well-controlled office BP (OBP), the clinical predictors of MH and to evaluate the gap (ie, the `mask effect' (ME)) between OBP and HBP.
METHODS AND RESULTS: BP was measured at the outpatient clinic and at home in 1,019 treated hypertensive patients. Candidate predictors for MH were analyzed within 511 patients with well-controlled OBP (45.6% men, 57.1±9.0 years). Among them, the prevalence of MH was 20.9% (n=107). In the multivariate-adjusted analysis, the risk of MH increased with high serum fasting blood glucose level (odds ratio (OR) 1.009, 95% confidence interval (CI): 1.001-1.018, P=0.020), higher systolic OBP (OR 1.075, 95%CI 1.045-1.106, P<0.001), higher diastolic OBP (OR 1.045, 95%CI 1.007-1.084, P=0.019) and the number of antihypertensive medications (OR 1.320, 95%CI 1.113-1.804, P=0.021). Furthermore, systolic HBP correlated well with systolic OBP (r=0.351, P<0.001) and with the degree of systolic ME (r=-0.672, P<0.001).
CONCLUSIONS: To recognize MH, it is practical to investigate those patients who are taking multiple antihypertensive drugs and have a high OBP with a high FBG level. The term "ME" identifies MH more appropriately than the term "negative white-coat effect".
Sung-Ji Park; Jeong Bae Park; Dong-Ju Choi; Ho Joong Youn; Chang Gyu Park; Young Keun Ahn; Joon-Han Shin; Dong Woon Kim; Se Joong Rim; Jang Ho Bae; Hyun Young Park;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-10-30
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-05-23     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  357-65     Citation Subset:  IM    
SungKyunKwan University, Samsung Medical Center, Seoul, Republic of Korea.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Blood Glucose / analysis
Blood Pressure Monitoring, Ambulatory
C-Reactive Protein / analysis
Delayed Diagnosis
Fasting / blood
Hospitals, University
Hypertension / diagnosis*,  drug therapy,  psychology
Lipids / blood
Middle Aged
Office Visits
Reg. No./Substance:
0/Antihypertensive Agents; 0/Blood Glucose; 0/Lipids; 9007-41-4/C-Reactive Protein

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