Masked hypertension incidence and risk factors in a prospective cohort study

Trudel, Xavier; Brisson, Chantal; Gilbert-Ouimet, Mahée; Duchaine, Caroline; Dalens, Violaine; Talbot, Denis; Milot, Alain

doi:10.1177/2047487318802692

Cited by 33 publications

(13 citation statements)

References 31 publications

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“…The prevalence of white-coat hypertension remained stable with a slight trend to decline through the age groups, whereas that of masked hypertension steadily increased. The increased prevalence of masked hypertension in the elderly can be explained by the increased prevalence of nocturnal hypertension, as suggested by previous large population studies [2,4,[29][30][31]. This finding, coupled with the evidence that masked hypertension is associated with an increased risk of fatal and nonfatal cardiovascular events, with a risk profile similar to that of sustained hypertension, further supports the importance of ABPM for an improved hypertension evaluation and management [32].…”

Section: Discussionsupporting

confidence: 69%

Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project

Omboni

Ballatore

Rizzi

et al. 2022

Journal of Hypertension

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Objectives: Ambulatory blood pressure monitoring (ABPM) provides extensive information on several BP parameters other than the average BP during daily life. Through this analysis of the TEMPLAR study, we sought to understand better the features of age-related changes in ABP patterns and phenotypes.Methods: ABPMs were obtained in 53 350 individuals visiting 866 Italian community pharmacies (age 3-101 years, 54.3% female individuals). ABPM patterns were assessed across 10-year age categories.Results: SBP steadily increased with age. DBP increased from the youth to the middle adulthood and then declined. Daytime BP was higher than night-time BP, but the difference narrowed with aging, reducing the prevalence of dippers. An enhanced SBP morning surge and increased prevalence of abnormal morning rise were observed with aging. SBP and DBP variabilities increased with age with a typical U or J shape, more evident in the case of DBP. The proportion of participants with ambulatory hypertension increased with age. However, an elevated daytime BP was more common in younger individuals and elevated night-time hypertension in older individuals. The prevalence of white-coat hypertension remained stable or slightly declined through the age groups, whereas that of masked hypertension steadily increased. Conclusion:Our results confirm that ABP patterns interplay and change in a complex way with age. Such changes, particularly the age-related increase in BP variability and prevalence of nocturnal hypertension, nondipping, enhanced morning rise, and masked hypertension, may increase the risk of cardiovascular events and must be carefully considered by the physician when managing BP in the elderly.

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Section: Discussionsupporting

confidence: 69%

Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project

Omboni

Ballatore

Rizzi

et al. 2022

Journal of Hypertension

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“…The traditional related factors for hypertension include genetic factors and environmental factors (such as diet, mental stress and smoking, etc.). Previous studies found that age, sex, smoking history, drinking history, BMI, diabetes history and cardiovascular history of family members were related factors for MH (Wang et al, 2017;Kario et al, 2019;Trudel et al, 2019), and related factors for WCH included smoking history, alcohol consumption history, age and sex (Afsar, 2013;Omboni et al, 2016;Kario et al, 2019). In the current study, we found that smoking and family history of coronary heart disease were related factors for WCH.…”

Section: Comparison With Prior Worksupporting

confidence: 58%

Prevalence and Related Factors of White Coat Hypertension and Masked Hypertension in Shunde District, Southern China

et al. 2022

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Background: White coat hypertension (WCH) and masked hypertension (MH) can increase the risk of target organ damage. Home blood pressure monitoring is an important method for detecting WCH and MH. However, the prevalence and related factors of WCH and MH in China have been rarely reported.Objective: To explore the prevalence and related factors associated with white coat hypertension (WCH) and masked hypertension (MH) in Shunde District, Southern China.Methods: This study recruited subjects from the Physical Examination Center in Shunde Hospital, Southern Medical University. Office blood pressure and home blood pressure values were collected using the home blood pressure monitor with telemedicine device and office blood pressure monitor, and the prevalence of WCH and MH was calculated by the values. Multivariate logistic regression was used to explore the related factors for WCH and MH.Results: Four-hundred and sixty-one participants (61% male), with an average age of 49 years, were included. The prevalence of WCH and MH was 5.1 and 15.2%, respectively. Multivariate logistic regression analysis showed that smoking (OR = 4.71, 95% CI = 1.05–21.15) and family history of coronary heart disease (OR = 4.51, 95% CI = 1.08–18.93) were associated with higher odds of WCH. The associated factors for higher odds of MH were smoking (OR = 2.83, 95% CI = 1.11–7.23), family history of hypertension (OR = 2.17, 95% CI = 1.11–4.26) and family history of coronary heart disease (OR = 2.82, 95% CI = 1.07–7.45).Conclusion: WCH and MH are highly prevalent in the Physical Examination Center in Shunde Hospital, Southern Medical University. We found smoking and family history of coronary heart disease were related factors for WCH, and smoking, family history of hypertension and coronary heart disease were associated with the odds of MH. Home blood pressure monitoring with a telemedicine device should be recommended to identity abnormal BP phenotype.

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“…Other studies in Africa have reported a higher prevalence of MUCH between 23% and 34.6% . Previous findings indicate that older age, male sex, increased BMI, smoking, and alcohol intake predict occurrence of masked hypertension. Risk of adverse cardiovascular events is higher in patients with MUCH compared to WUCH and controlled hypertension, also MUCH and TUCH predispose patients to similar risk of adverse cardiovascular outcomes and all‐cause mortality .…”

Section: Discussionmentioning

confidence: 91%

Ambulatory blood pressure monitoring and management of hypertension at a cardiac clinic in Kumasi Metropolis, Ghana

Nsutebu

Owusu

Buabeng

et al. 2020

J of Clinical Hypertension

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Ambulatory blood pressure monitoring (ABPM) is considered a good intervention strategy to avoid misdiagnosis of hypertension and allow for targeted treatment of patients with hypertension. This study sought to assess the contribution of ABPM to blood pressure (BP) control and antihypertensive therapy at a cardiac clinic in Ghana.Medical records of 97 patients, aged 18-85 years (mean 55), were reviewed. Among patients with clinic BP (CBP) and ambulatory BP recorded on the same day, we assessed for the different hypertension phenotypes, CBP control 6 months following ABPM, and changes to antihypertensive therapy after review of the ABPM records in patients with controlled and uncontrolled ambulatory BP. From the clinic and ambulatory BP records measured at baseline, the proportion of patients with white-coat uncontrolled hypertension (WUCH) was 19.5% (17/87) and those with masked uncontrolled hypertension (MUCH) was 16.1% (n = 14). A significant reduction in average systolic CBP in the overall cohort (−6.2 mm Hg, P < .01) and in the uncontrolled subgroup (−8.8 mm Hg, P < .001) at follow-up was observed. After review of the ABPM records, 51.7% of the patients on treatment had changes made in their antihypertensive therapy. Antihypertensive therapy was deintensified or left unchanged in majority of the patients with WUCH and sustained controlled hypertension. In patients with MUCH and true uncontrolled hypertension (TUCH), therapy was intensified. In conclusion, ABPM improved clinical decision-making for antihypertensive therapy and BP control. ABPM should therefore be used more often in hypertension and cardiac clinics in low/middle-income countries for optimal care. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Nsutebu N, Owusu IK, Buabeng KO, Bonsu KO. Ambulatory blood pressure monitoring and management of hypertension at a cardiac clinic in Kumasi Metropolis, Ghana. J Clin Hypertens. 2020;22:605-613.

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Masked hypertension incidence and risk factors in a prospective cohort study

Cited by 33 publications

References 31 publications

Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project

Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project

Prevalence and Related Factors of White Coat Hypertension and Masked Hypertension in Shunde District, Southern China

Ambulatory blood pressure monitoring and management of hypertension at a cardiac clinic in Kumasi Metropolis, Ghana

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