Frequency and Related Factors of Masked Hypertension at a Worksite in Korea

Abstract

ObjectivesMasked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers.MethodsThe study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension.ResultsThe frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129/80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129 / 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139 / 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09).ConclusionsThe frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.

Frequency of masked hypertension and its relation to target organ damage in the heart

“…The incidence of MH was 37% which is relatively high, whereas WCH was 7%, SH was 31% and true normotension was 25%. These data are in accordance with Kim et al, 12 , Ga et al, 13 , the working group for the study of MH in Spain 14 and Selenta et al 15 In our study, the incidence of WCH was relatively low (7%), this is in accordance with Kim et al, 12 , and contradictory to Ali et al, 16 and Manning et al 17 The explanation of the high incidence of MH and low incidence of WCH in our study population is not clear. This may be caused by reduced white coat effect after the patient is rested and multiple blood pressure readings taken.…”

“…19 DM was significantly higher in SH than MH, also, it was significantly higher in MH than true normotensive patients, however, there was no difference between MH and WCH. This is in accordance with Takeno et al, 22 and contradictory to Eguchi et al 23 Obesity defined by BMI was significantly higher in SH than MH, there was no difference between MH and WCH or true normotensive patients, this is discordant with Kotsis et al, 24 and Kim et al 12 There was no significant difference between MH and SH regarding nocturnal dipping, however, it was significantly less in MH than WCH and true normotensive patients. As diminished nocturnal decline in BP is a risk factor for CV mortality, independent of the overall BP load during a 24 h period, in the general population, 15 so MH carries more risk than WCH and true normotension and similar risk as SH.…”

“…11 ABPM enables the continuous observance of changes in BP during activities of daily life, so that BP can be measured automatically at specific time intervals (every 30 min or every hour), resulting in very accurate measurements of BP. 12 …”

Prevalence of masked hypertension and associated factors in normotensive healthcare workers

“…This may be because study populations differ widely between studies. Although data from epidemiological studies suggest that the prevalence of 'Masked phenomenon' in treated hypertensives, called isolated office control, tends to be higher in treated hypertensives, the prevalence in the general population is not inconsiderable, ranging between 8% [21], 9% [22], 23% [23], and even 25.6% at a worksite in Korea [24]. To date, there are no data in Spain on the prevalence of MHT in normotensive individuals.…”

Homocysteine levels in patients with masked hypertension

“…With 24 hours blood pressure monitoring, both false negativities and false positivities have been significantly decreased (6,7). In crosssectional studies, when the patients with the MHT have been compared with patients with normal clinic and ambulatory blood pressure, it is shown that the target organ damage prevalence has been quite much higher and the mortality and morbidity ratios have increased (8,9). Recent studies are goal to research the effect of MHT on the endothelial dysfunction and the relation of it with the rising inflammation biomarkers in patients (10,11).…”