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Masked hypertension ‘raises risk of CVD’

By Christian Duffin

Patients with masked hypertension who remain untreated initially are at higher risk for cardiovascular events than normotensive individuals, according to the results of a meta-analysis.

Researchers made these findings from a meta-analysis of eight studies involving nearly 8,000 patients with normal, sustained hypertension, masked hypertension (defined as a normal clinic but high out-of-clinic blood pressure) or white coat hypertension (high clinic but normal out of clinic blood pressure).

Patients with normal blood pressure had a reading between no higher than 140/90 mmHg. Those with masked hypertension had a reading in clinic of less than 140/90 mmHg but an out-of-clinic reading higher than 135/85 mmHg.

Those with white coat hypertension had a blood pressure above 140/90 mmHg in clinic but less than 135/85 mm Hg out of clinic BP and patients with sustained hypertension always had a blood pressure reading above 135/85 mmHg.

In all, 696 cardiovascular events, namely stroke, peripheral vascular disease, and cardiac disease, occurred over follow-up periods ranging from three to 13 years.

After adjustment for cardiovascular disease risk factors the risk for cardiovascular events did not significantly differ between patients with white coat hypertension and those with normotension.

But patients with masked hypertension or sustained hypertension had 2.09- and 2.59-fold higher risks, respectively, for cardiovascular events than normotensive individuals.

Lead researcher Dr Sante Pierdomenico, from the department of medicine at Gabriele d'Annunzio Univieristy in Chieti, Italy, concluded: ‘As some subjects with white coat hypertension could develop sustained hypertension during time, it should be interesting to evaluate whether events might occur in those with persistent white coat hypertension or in those who develop sustained hypertension.'

Am J Hypertens 2011; 24: 52-58.

Masked hypertension 'raises risk of CVD'