The MUSCAT Study: A Multicenter PROBE Study Comparing the Effects of Angiotensin II Type-1 Receptor Blockers on Self-Monitored Home Blood Pressure in Patients with Morning Hypertension: Study Design and Background Characteristics

Uchida, Haruhito A.; Nakamura, Yoshio; Kaihara, Masanobu; Norii, Hisanao; Hanayama, Yoshihisa; Makino, Hírofumi

doi:10.1291/hypres.31.51

Cited by 8 publications

(10 citation statements)

References 51 publications

(51 reference statements)

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“…There was substantial heterogeneity between studies (I 2 statistic 83.7%; Figure 3). The study of Uchida et al (13) was statistically influential in inflating the prevalence estimates, and omitting this study reduced the prevalence of masked hypertension among those who had normotension in clinic to 33.0% (95% CI 25.5 to 40.5%) and also reduced the between-study heterogeneity (I 2 statistic 53.8%). The thresholds for classification of clinic and out-of-office hypertension were heterogeneous ( Table 2).…”

Section: Resultsmentioning

confidence: 94%

“…A total of 54 studies were obtained from our search, six of which were of adults with CKD and used for analysis (13)(14)(15)(16)(17)(18). The reasons for exclusion are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…In four studies, all patients had CKD (14,15,17,18), whereas the other two studies (13,16) defined the percentage of patients with CKD. In three studies (13)(14)(15), all patients were treated with antihypertensive drugs, in one study none of the patients were treated with antihypertensive drugs (16), and in two studies (17,18) mostly treated patients (approximately 90%) were included in the study. Four of the studies used self BP monitoring (13)(14)(15)(16) and two studies (17,18) used 24-h BP monitoring as the reference standard.…”

Section: Resultsmentioning

confidence: 99%

“…Masked hypertension was defined as clinic BP of Ͻ130 mmHg and ambulatory BP Ն130 mmHg in two studies (17,18), clinic BP of Ͻ140 mmHg and home BP Ն130 mmHg in two studies (14,15), and clinic BP of Ͻ140 mmHg and home BP Ն135 mmHg in two studies (13,16). One study (16) measured home BP in triplicate, twice daily for 4 d, whereas others measured it over 2 wk to 1 mo but only in the morning (13)(14)(15). The provenance of heterogeneity was explored by analyzing the studies by various definitions of masked hypertension used by the authors.…”

Section: Resultsmentioning

confidence: 99%

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Masked Hypertension and White-Coat Hypertension in Chronic Kidney Disease

Bangash

Agarwal

2009

Clinical Journal of the American Society of Nephrology

131

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Background and objectives: Poor hypertension control observed in patients with chronic kidney disease (CKD) may in part be due to the suboptimal assessment of BP with clinic BP measurements alone. The goal of this meta-analysis was to estimate the prevalence and determinants of white-coat and masked hypertension in the adult CKD population.Design, setting, participants, & measurements: Articles reporting prevalence of masked and white-coat hypertension in patients with CKD were obtained from two major databases. We then performed a meta-analysis to derive pooled estimates of prevalence and determinants of these two conditions.Results: Among 980 patients with CKD identified in six studies, the overall prevalence of masked hypertension was 8.3% and of white-coat hypertension was 18.3%. More alarming, 40.4% of patients who had CKD and were thought to have normotension (or adequately treated hypertension) in fact had hypertension at home. Also 30.0% of patients who had CKD and were thought to have hypertension had normotension at home. The thresholds for classification of clinic and ambulatory BP as hypertensive strongly influenced the risk for diagnosis of masked hypertension in favor of white-coat hypertension.Conclusions: Because clinic BP measurements alone lead to substantial misclassification in BP, we estimate that the prevalence of poorly controlled hypertension is likely less than currently estimated. Out-of-office BP monitoring may improve the management of hypertension in patients with CKD. Standardized definitions for the diagnosis of masked and white-coat hypertension would facilitate research.

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Section: Resultsmentioning

confidence: 94%

“…A total of 54 studies were obtained from our search, six of which were of adults with CKD and used for analysis (13)(14)(15)(16)(17)(18). The reasons for exclusion are shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Masked Hypertension and White-Coat Hypertension in Chronic Kidney Disease

Bangash

Agarwal

2009

Clinical Journal of the American Society of Nephrology

131

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“…Some data may suggest that. In a small prospective trial on nondiabetic Includes treated Treatment naive Bobrie et al [10] Bjorklund et al [6] Pierdomenico et al [19,20] Franklin et al [15] Pogue et al [25] Selenta et al [36] Hara et al [11] Sega et al [3] Tomiyama et al [24] Matsui et al [7] Ohkubo et al [37] Ben-Dov et al [31] Uchida et al [18] Kuriyama et al [23] Hanninen et al [4] Mancia et al [9] Kotsis et al [5] Hansen et al [8] treated hypertensives, those patients who were able to achieve BP control in both OBP and ABP settings demonstrated reduction in LVMI and microalbuminuria, along with other indices. In contrast, those patients whose OBP was controlled, but not the out-of-office readings, demonstrated no such benefit [22].…”

Section: Limitationsmentioning

confidence: 99%