Pressor response to 30-s breathhold: A predictor of masked hypertension

Abstract

One in six adults has normal arterial blood pressure (BP) during a routine examination, but is hypertensive in other environments. This masked hypertension (MHT) may delay treatment until target organ damage has occurred. A sensitive, specific and economical test is needed to detect or exclude MHT in apparently normal subjects. The BP response to a 30-s breathhold (BH test) was observed in 269 young subjects with no evidence of cardiovascular disease. Of 226 normotensives (office BP ≤ 120/80), 25 (11%) had a positive BH test (test BP > 140/90 mmHg), and 12 (44%) of these subjects had MHT (positive 24-h ambulatory BP monitoring (BPM)). Of 201 subjects with negative BH test, none had MHT (negative BPM). Of 43 subjects with high normal BP (office BP > 120/80 < 140/90), 28 (65%) had a positive BH test and 22 of these subjects had MHT (positive BPM). Of the 15 subjects with high normal BP and with a negative BH test, none had MHT (negative BPM). Overall, the BH pressor test and BPM agreed in 93% of cases, and the BH test produced no false negative findings. The BH pressor test effectively ruled out MHT in normal subjects and accurately identified a population that should be further evaluated for MHT.

Screening for Hypertension in Adults

“…In total, 52 studies reported in 81 articles were included (Figure 2). For all KQs, additional descriptive and outcome data are available in the full report.…”

“…Twenty fair- to good-quality studies (n = 12 614) examined the test accuracy of OBPM for initial screening for hypertension compared with ABPM (eTable 3 in the Supplement). Participants in the studies were primarily recruited from community-based samples. Only 5 were conducted in the US.…”

Specifics of neurohumoral activity and clinical presentation of masked arterial Hypertension in young males

“…Пациентам, не имеющим анамнеза сердечно-сосудистых заболеваний, и с уровнем офисного АД меньше 140 и 90 мм рт.ст. дополнительно проводились проба с добровольной 30-секундной задержкой дыхания на выявления МАГ [8,[10][11] и 24-часовое СМАД. Тест расценивался как положительный при уровне АД ≥140/90 мм рт.ст.…”

Masked Hypertension in Young Persons: Prevalence, Significance of Cardiovascular Risk Factors and Prognosis by Gender Differences

“…Тест задержки дыхания прово-дился медицинским персоналом согласно методике [7,8,12]. Исходный уровень АД измеряли у лиц не менее двух раз в положении сидя.…”

“…для выявления МАГ [7,8,12]. Обследуемые непосредственно перед проведением пробы отдыхали на протяжении 30 минут в положе-нии сидя, за 2 часа не принимали тонизирующих и стимулирующих напитков и лекарственных препа-позиции в структуре смертности, к 2020г достигнут своего общемирового значения [2].…”