Document Detail

Masked hypertension and target organ damage in treated hypertensive patients.
MedLine Citation:
PMID:  16942927     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent studies have shown that an elevated ambulatory or home blood pressure (BP) in the absence of office BP-a phenomenon called masked hypertension-is associated with poor cardiovascular prognosis. However, it remains to be elucidated how masked hypertension modifies target organ damage in treated hypertensive patients. METHODS: A total of 332 outpatients with chronically treated essential hypertension were enrolled in the present study. Patients were classified into four groups according to office (<140/90 or >or=140/90 mm Hg) and daytime ambulatory (<135/85 or >or=135/85 mm Hg) BP levels; ie, controlled hypertension (low office and ambulatory BP), white-coat hypertension (high office but low ambulatory BP), masked hypertension (low office but high ambulatory BP), and sustained hypertension (high office and ambulatory BP). Left ventricular mass index, carotid maximal intima-media thickness, and urinary albumin levels were determined in all subjects. RESULTS: Of the patients, 51 (15%), 65 (20%), 74 (22%), and 142 (43%) were identified as having controlled hypertension, white-coat hypertension, masked hypertension, and sustained hypertension, respectively. Left ventricular mass index, maximal intima-media thickness, and urinary albumin level in masked hypertension were significantly higher than in controlled hypertension and white-coat hypertension, and were similar to those in sustained hypertension. Multivariate regression analyses revealed that the presence of masked hypertension was one of the independent determinants of left ventricular hypertrophy, carotid atherosclerosis, and albuminuria. CONCLUSIONS: Our findings indicate that masked hypertension is associated with advanced target organ damage in treated hypertensive patients, comparable to that in cases of sustained hypertension.
Mari Tomiyama; Takeshi Horio; Masayoshi Yoshii; Shin Takiuchi; Kei Kamide; Satoko Nakamura; Fumiki Yoshihara; Hajime Nakahama; Takashi Inenaga; Yuhei Kawano
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  19     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-31     Completed Date:  2007-05-09     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  880-6     Citation Subset:  IM    
Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Albuminuria / etiology*,  metabolism,  physiopathology
Analysis of Variance
Antihypertensive Agents / therapeutic use*
Biological Markers / blood,  urine
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Carotid Artery, Common / physiopathology,  ultrasonography
Carotid Stenosis / etiology*,  physiopathology,  ultrasonography
Chronic Disease
Circadian Rhythm
Hypertension / complications*,  drug therapy*,  physiopathology,  ultrasonography
Hypertrophy, Left Ventricular / etiology*,  physiopathology,  ultrasonography
Middle Aged
Office Visits
Treatment Outcome
Ultrasonography, Interventional
Reg. No./Substance:
0/Antihypertensive Agents; 0/Biological Markers
Comment In:
Am J Hypertens. 2006 Sep;19(9):887-8   [PMID:  16942928 ]

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