Determinants of masked hypertension in hypertensive patients treated in a primary care setting

Abstract

Our results indicate that one of five hypertensive patients and more than one of three with controlled OBP will have MH. MH is associated with other cardiovascular risk factors, such as diabetes, and in nondiabetics, with male sex, older age and obesity.

Home or ambulatory blood pressure monitoring for the diagnosis of hypertension?

“…Somehow surprisingly, however, authors did not find an association between masked hypertension and advanced age, diabetes mellitus, and, more in general, major cardiovascular risk factors, a finding which is in contrast with other population studies [9][10][11].…”

Identifying masked uncontrolled hypertension in the community pharmacy setting

“…Thus, the factors associated with MUCH should be studied independently in both of these settings. As a reasonable starting point, our primary analysis included and checked many factors that have been associated previously with MUCH in the physician office: sex [5][6][7], age [5][6][7], smoking status [6], clinic BP [5][6][7][8][9] (instead of CPBP), BMI [5,8], number of antihypertensive drugs taken [8,9], and diabetes [5]. In our opinion, other potential factors [21] might be taken into account in the future, also considering undiagnosed patients and large samples.…”

“…As a consequence, if normal BP figures are measured in the physician's office, the necessary adjustments in treatment may not be made and the underlying risk associated with elevated ABP or HBP would therefore not be well managed. As measurement of out-of-office BP in all normotensive individuals is not a feasible or an efficient strategy in daily clinical practice, several studies have been carried out to identify the factors associated with the presence of MUCH [5][6][7][8][9]. By considering these factors and identifying patients who are more likely to have MUCH, a further assessment, using ABP or HBP monitoring (ABPM or HPBM), could be recommended.…”

Masked hypertension

“…Of 5,636 Canadian persons with hypertension treated in a primary care setting, 19.6% and 36.8% of persons with controlled office blood pressure had masked uncontrolled hypertension (16). Diabetes mellitus, older age, male gender, obesity, and higher office systolic blood pressure were associated with masked uncontrolled hypertension (16).…”

“…Diabetes mellitus, older age, male gender, obesity, and higher office systolic blood pressure were associated with masked uncontrolled hypertension (16). Of 803 persons, mean age 60 years, with treated and controlled office blood pressure, 32.1% had masked uncontrolled hypertension (17).…”