Prevalence of masked hypertension and associated factors in normotensive healthcare workers

Sobrino, Javier; Doménech, Mónica; Camafort, Miguel; Vinyoles, Ernest; Coca, António

doi:10.1097/mbp.0000000000000002

Cited by 19 publications

(14 citation statements)

References 22 publications

(33 reference statements)

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“…Both Okosun IS et al and Agyemang C et al have ever found that ethnic difference can influence the prevalence of hypertension and prehypertension [ 25 , 26 ]. Subjects with family history of cardiovascular diseases had higher risk of prehypertension like previous findings [ 27 , 28 ]. Consequently, people whose parents have suffered from cardiovascular diseases should supervise their blood pressure level more frequently.…”

Section: Discussionsupporting

confidence: 82%

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey

Liu

Zhu

et al. 2016

BMC Public Health

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BackgroundUp to date, most of previous studies about Chinese prehypertension were conducted based on a small sample or in only one province, which could not represent the general population in China. Furthermore, no information on the ethnic difference in prevalence of prehypertension has been reported in China. The aim of this study is to examine the sex-specific, age-specific and ethnic-specific prevalence of prehypertension and associated risk factors in a large-scale multi-ethnic Chinese adult population.MethodsThe subjects came from a large-scale population survey about Chinese physiological constants and health conditions conducted in six provinces. 47, 495 adults completed blood pressure measurement. Prehypertension was defined as not being on antihypertensive medications and having SBP of 120–139 mmHg and/or DBP of 80–89 mmHg. Odds ratio (OR) and its 95 % confidence interval (CI) from logistic models were used to reflect the prevalence of prehypertension.ResultsThe mean age of all subjects was 43.9 ± 16.8 years. The prevalence of hypertension and prehypertension for all them was 29.5 and 36.4 %, respectively. The prevalence of hypertension and prehypertension for males (33.2 and 41.1 %, respectively) was higher than that for females (27.0 and 33.2 %, respectively), and P < 0.001. The mean age of the subjects was 54.8 ± 14.0 years for hypertensive, 44.0 ± 16.0 years for prehypertensive and 35.3 ± 14.5 years for normotensive. With aging, subjects had more odds of getting prehypertension. Multivariate logistic model indicated that males (OR = 2.076, 95 % CI: 1.952–2.208), laborers with mental work (OR = 1.084, 95 % CI: 1.020–1.152), Yi (OR = 1.347, 95 %CI: 1.210–1.500) and Hui subjects (OR = 1.133, 95 % CI: 1.024–1.253), alcohol drinkers (OR = 1.147, 95 % CI: 1.072–1.228), the generally obese (OR = 2.460, 95 % CI: 2.190–2.763), the overweight (OR = 1.667, 95 % CI: 1.563–1.788), the abdominally obese (OR = 1.371, 95 % CI: 1.280–1.467) and subjects with family history of cardiovascular diseases (OR = 1.132, 95 % CI: 1.045–1.226) had higher prevalence of prehypertension. Subjects with higher educational level (OR = 0.687, 95 % CI: 0.627–0.752 for university) and Miao (OR = 0.753, 95 % CI: 0.623–0.910), Tibetan (OR = 0.521, 95 % CI: 0.442–0.613), Tujia (OR = 0.779, 95 % CI: 0.677–0.898) subjects had lower prevalence.ConclusionHigh prevalence rate of prehypertension was general in Chinese adults. Many sociodemographic characteristics were significantly associated with prehypertension. There were important clinical significance and public health significance about age-specific, gender-specific and ethnic-specific Chinese prehypertension conditions studies.

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Section: Discussionsupporting

confidence: 82%

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey

Liu

Zhu

et al. 2016

BMC Public Health

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“…However, the c-statistic for discriminating between participants with versus without masked hypertension was similar or lower using predicted ASCVD risk when compared with clinic SBP and clinic DBP. Despite the prior evidence that several ASCVD risk factors are associated with masked hypertension, 1, 2, 21, 28, 29 clinic BP, particularly in the prehypertension range, 1, 6, 20, 26 may be sufficient for identifying individuals with masked hypertension.…”

Section: Discussionmentioning

confidence: 91%

Predicted Atherosclerotic Cardiovascular Disease Risk and Masked Hypertension Among Blacks in the Jackson Heart Study

Anstey

Booth

Abdalla

et al. 2017

Circ: Cardiovascular Quality and Outcomes

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Background Among individuals without hypertension based on clinic blood pressure (BP), it is unclear who should be screened for masked hypertension, defined as having hypertension based on out-of-clinic BP. We hypothesized that individuals with a higher 10-year predicted atherosclerotic cardiovascular disease (ASCVD) risk, calculated using the Pooled Cohort risk equations, have a higher prevalence of masked hypertension. Methods and Results We analyzed data from the Jackson Heart Study, a population-based cohort of African Americans, to determine the association of predicted ASCVD risk with masked hypertension. The sample included 644 participants, 40–79 years of age, with clinic systolic/diastolic BP <140/90 mmHg, who completed ambulatory BP monitoring (ABPM), were free of cardiovascular disease, and had data on factors needed to calculate ASCVD risk. Ten-year predicted ASCVD risk was calculated using the Pooled Cohort risk equations. Any masked hypertension was defined as masked daytime hypertension (mean daytime systolic/diastolic BP≥135/85 mmHg), masked nighttime hypertension (mean nighttime systolic/diastolic BP≥120/70 mmHg), or masked 24-hour hypertension (mean 24-hour systolic/diastolic BP≥130/80 mmHg). The prevalence of any masked hypertension was 54.0%. Compared to participants in the lowest (<5%) predicted ASCVD risk category, multivariable adjusted prevalence ratios (95% confidence interval [CI]) for any masked hypertension were 1.36 (1.03–1.79), 1.62 (1.22–2.16), and 1.91 (1.47–2.48) for those with ASCVD risk of 5% to <7.5%, 7.5% to <10%, and ≥10%, respectively. The c-statistic for discriminating between participants with versus without any masked hypertension was 0.681 (95% CI 0.640–0.723) for ASCVD risk and 0.703 (95% CI 0.662–0.744) for clinic SBP and DBP. Conclusions Higher ASCVD risk was associated with an increased prevalence of masked hypertension. Although the discrimination of ASCVD risk for masked hypertension was not superior to clinic BP, risk prediction equations may be useful for identifying the subgroup of individuals with both masked hypertension and high predicted ASCVD risk.

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“…2013 [ 45 ] Turkey Health care Outpatient Non-HT No medication 35.8 51.1 140/90 2/1 – Daytime (9–21.00) 135/85 Sobrino J. 2013 [ 46 ] Spain Community General population Non-HT No medication 43.1 44.7 140/90 3/1 – 24-h 130/80 Daytime 135/85 Franklin S 2013 [ 47 ] Europe Japan Community General population Non-HT Mixed – – 140/90 2/1 – Daytime 135/85 Larsen T 2014 [ 48 ] America Health care Outpatient Non-HT No medication 49.8 47 140/90 1/3 – 24-h 135/85 Viera A 2015 [ 49 ] America Health care Outpatient Non-HT …”

Section: Resultsmentioning

confidence: 99%

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Karnjanapiboonwong

Anothaisintawee

Chaikledkaew

et al. 2020

BMC Cardiovasc Disord

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Background Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM, reporting sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-h ABPM as the reference standard, were 74% (95% CI: 65–82%), 79% (95% CI: 69%, 87%), and 11.11 (95% CI: 6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI 0.19, 0.29) and 0.29 (95% CI 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71% (95% CI 61%, 80%), 82% (95% CI 77%, 87%), and 11.60 (95% CI 8.98, 15.13), respectively. Conclusions Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-h ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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Prevalence of masked hypertension and associated factors in normotensive healthcare workers

Abstract: The prevalence of MHT in normotensive healthcare workers in Spain is almost 25%. Therefore, 24-h ambulatory BP monitoring should be routine in occupational health checks in health workers, especially men.

Cited by 19 publications

References 22 publications

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey

Predicted Atherosclerotic Cardiovascular Disease Risk and Masked Hypertension Among Blacks in the Jackson Heart Study

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

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