Untreated masked hypertensive subjects detected by home blood pressure measurement at increased risk for subclinical arterial damage

Masked hypertension (MHT), defined as normal office blood pressure (BP) coexisting with elevated out-of-office BP, is increasingly considered as a risk marker/factor for target-organ damage. This study was designed to investigate subclinical arterial damage as measured by carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) in unmedicated subjects with masked hypertension by means of home BP measurement. A total of 282 subjects not taking any antihypertensive medication, with at least one of the following cardiovascular risk factors - high BP, hyperlipidaemia, diabetes, current smoking, and chronic kidney disease - were recruited. Subjects were divided in four groups depending on office BP (140/90 mm Hg) and home BP (135/85mm Hg) measurements: normotension (NT), white-coat hypertension (WCHT), MHT, and sustained hypertension (SHT). After adjusting for covariates, carotid IMT was the highest in MHT among the four groups (all P<0.01) whilst baPWV was significantly higher in MHT as compared to NT and WCHT (P<0.01).

Abstract

Keywords:
Atherosclerosis – Cardiovascular risk – Diabetes – Elevated blood pressure – Hyperlipidaemia – Kidney disease – Smoking