Document Detail

Masked hypertension: evaluation, prognosis, and treatment.
MedLine Citation:
PMID:  20508623     Owner:  NLM     Status:  MEDLINE    
Blood pressure (BP) may be high during usual daily life in one out of 7-8 individuals with normal BP in the clinic or doctor's office. This condition is usually defined as masked hypertension (MH). Prevalence of MH varied across different studies depending on patient characteristics, populations studied, and different definitions of MH. Self-measured BP and ambulatory BP (ABP) have been widely used to identify subjects with MH. Various factors have been identified as possible determinants of MH. Cigarette smoking, alcohol, physical activity, job, and psychological stress may increase BP out of the clinical environment in otherwise normotensive individuals, leading to MH. In most studies, target organ damage was comparable in subjects with MH and those with sustained hypertension, and greater than in those with true normotension. Subjects with MH showed a 1.5- to 3-fold higher risk of major cardiovascular (CV) disease than those with normotension, and their risk was not different from that of patients with sustained hypertension. In an overview of literature, we found that the risk of major CV disease was higher in subjects with MH than in the normotensive subjects regardless of the definition of MH based on self-measured BP (hazard ratio (HR) 2.13; 95% confidence interval (CI): 1.35-3.35; P = 0.001) or 24-h ABP (HR 2.00; 95% CI: 1.54-2.60; P < 0.001). MH is an insidious and prognostically adverse condition that can be reliably diagnosed by self-measured BP and ABP. MH should be searched for in subjects who appear to be more likely to have this condition. Antihypertensive treatment is envisaged in these subjects, although the associated outcome benefits are still undetermined.
Fabio Angeli; Gianpaolo Reboldi; Paolo Verdecchia
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-05-27
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-12-07     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  941-8     Citation Subset:  IM    
Department of Cardiology, Clinical Research Unit-Preventive Cardiology, Hospital 'S. Maria della Misericordia', Perugia, Italy.
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MeSH Terms
Alcohol Drinking / adverse effects
Blood Pressure Monitoring, Ambulatory
Cardiovascular Diseases / epidemiology,  etiology
Cross-Sectional Studies
Hypertension / complications,  diagnosis*,  drug therapy,  epidemiology*
Risk Factors
Smoking / adverse effects
Stress, Psychological

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