Masked Hypertension Assessed by Ambulatory Blood Pressure Versus Home Blood Pressure Monitoring: Is It the Same Phenomenon?

Stergiou, George S.; Salgami, Eleanna V.; Tzamouranis, D; Roussias, Leonidas G.

doi:10.1016/j.amjhyper.2005.01.003

Cited by 135 publications

(116 citation statements)

References 19 publications

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“…1 In line with other reports, 12,15 when home BP was used to diagnose MH, there was disagreement with the ambulatory BP diagnosis in 22%. This disagreement is probably due, at least in part, to random variation above and below the BP threshold, 15 and supports the view that home and ambulatory BP are interchangeable methods in the diagnosis of MH. 15 Similar proportions of subjects with MH are detected by ABP and HBP monitoring.…”

Section: Discussionmentioning

confidence: 61%

“…This disagreement is probably due, at least in part, to random variation above and below the BP threshold, 15 and supports the view that home and ambulatory BP are interchangeable methods in the diagnosis of MH. 15 Similar proportions of subjects with MH are detected by ABP and HBP monitoring. Although disagreement in the diagnosis between the two methods is not uncommon, in the majority of these cases, the deviation of the diagnostic BP above the threshold in not clinically important.…”

Section: Discussionmentioning

confidence: 61%

“…MH was defined as normal clinic BP (o140 mm Hg systolic and o90 mm Hg diastolic) but elevated daytime ambulatory BP (X135 mm Hg systolic and/ or 85 mm Hg diastolic), WCH as elevated clinic BP (X140 systolic and/or 90 diastolic mm Hg) but normal daytime ambulatory BP (o135 mm Hg systolic and o85 mm Hg diastolic) and SH as elevated clinic and daytime ambulatory BP. 3,15,16 The same threshold (X135 mm Hg systolic and/or 85 mm Hg diastolic) was used to diagnose MH on the basis of home BP measurements. Antihypertensive drug treatment remained unchanged in the last 4 weeks before and during the study.…”

Section: Study Populationmentioning

confidence: 99%

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Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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Masked hypertension is defined as low clinic and elevated out-of-clinic pressure (blood pressure, BP) assessed either by patients at home or by ambulatory monitoring. This study compared the cardiovascular status and psychometric characteristics of masked, white coat and sustained hypertensives. Three groups of consecutive subjects with masked (n ¼ 100, age 59 ± 11 years), white coat (n ¼ 100, 60 ± 10 years) and sustained hypertension (n ¼ 100, 60 ± 11 years) diagnosed by ambulatory BP monitoring were compared. Masked hypertensives had higher educational level, exercised more frequently, received fewer drugs and sensed more responsibilities at work than at home. Their left ventricular hypertrophy indexes fall inbetween those with white coat and sustained, the latter having the highest values. The estimated total cardiovascular risk was intermediate between white coat and sustained, whereas their cardiovascular morbidity and renal disease was higher than that of white coat and similar to sustained. Psychological profile analysis showed lower score for type-A personality and their mood behaviour in the hypomania-euthymia range compared with white coat and sustained hypertensives. The cardiovascular risk of masked hypertensives is higher than that of white coat and similar to sustained. Masked hypertensives have higher educational level, better physical training and different personality/mood pattern than white coat and sustained.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 61%

Section: Study Populationmentioning

confidence: 99%

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Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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“…Although the CHEP Recommendations Task Force recognized that additional evidence is required before recommendations regarding diagnosis and management of masked hypertension can be developed, the compelling evidence from the SHEAF study regarding the clinical implications of masked hypertension resulted in the new recommendation for 2006 that continued home/self BP monitoring be considered for treated hypertensive patients with BP controlled in the office but not at home (masked hypertension). The use of ABPM has also been used in the assessment of masked hypertension (30), and will be discussed in upcoming iterations of the CHEP guidelines as evidence from ongoing studies becomes available. The CHEP Recommendations Task Force felt it important to emphasize that adequate patient training is required to ensure accurate BP results from home/self BP monitoring.…”

Section: Reproduced With Permission From the Canadian Hypertension Edmentioning

confidence: 99%

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I – Blood pressure measurement, diagnosis and assessment of risk

Hemmelgarn

McAlister

Grover

et al. 2006

Canadian Journal of Cardiology

102

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OBJECTIVE: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with high blood pressure. OPTIONS AND OUTCOMES: For persons in whom a high blood pressure value is recorded, a diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the level of the blood pressure elevation, the approach used to monitor blood pressure (office, ambulatory or home/self), and the duration of follow-up. In addition, the presence of cardiovascular risk factors and target organ damage should be assessed to determine the urgency, intensity and type of treatment. For persons diagnosed as having hypertension, estimating the overall risk of adverse cardiovascular outcomes requires an assessment for other vascular risk factors and hypertensive target organ damage. EVIDENCE: MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. Reference lists were scanned, experts were polled, and the personal files of the authors and subgroup members were used to identify other studies. Identified articles were reviewed and appraised using prespecified levels of evidence by content and methodological experts. As per previous years, the authors only included studies that had been published in the peer-reviewed literature and did not include evidence from abstracts, conference presentations or unpublished personal communications. RECOMMENDATIONS: The present document contains recommendations for blood pressure measurement, diagnosis of hypertension, and assessment of cardiovascular risk for adults with high blood pressure. These include the accurate measurement of blood pressure, criteria for the diagnosis of hypertension and recommendations for follow-up, assessment of overall cardiovascular risk, routine and optional laboratory testing, assessment for renovascular and endocrine causes, home and ambulatory blood pressure monitoring, and the role of echocardiography for those with hypertension. Key features of the 2006 recommendations include continued emphasis on an expedited diagnosis of hypertension, an in-depth review of the role of global risk assessment in hypertension therapy, and the use of home/self blood pressure monitoring for patients with masked hypertension (subjects with hypertension who have a blood pressure that is normal in clinic but elevated on home/self measurement). VALIDATION: All recommendations were graded according to the strength of the evidence and were voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported herein received at least 95% consensus. These guidelines will continue to be updated annually.

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“…9 While ABPM and HBPM were each associated with outcomes, the authors concluded that there was insufficient evidence to consider either modality to be superior. Further, a study by Stergiou et al 10 found substantial disagreement between ABPM and HBPM when used to identify masked hypertension. Only 44% of participants had masked hypertension on both modalities.…”

mentioning

confidence: 99%

Masked hypertension—what lies ahead?

Anstey

Shimbo

2017

J Hum Hypertens

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Masked Hypertension Assessed by Ambulatory Blood Pressure Versus Home Blood Pressure Monitoring: Is It the Same Phenomenon?

Cited by 135 publications

References 19 publications

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part I – Blood pressure measurement, diagnosis and assessment of risk

Masked hypertension—what lies ahead?

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