Masked Hypertension: Does It Lead to CVD or CKD?

Abstract Objectives Previous studies from the developed countries showed that children born very low birth weight have a higher risk of hypertension compared with that of the normal birth weight controls. However, studies regarding the prevalence of hypertension in such children from the developing countries are scarce. This study aimed to identify the perinatal and postnatal factors associated with hypertension in children born very low birth weight. Results Forty-six children aged ≥ 6 years from the VLBW cohort of Ramathibodi Hospital, Bangkok, Thailand underwent the ambulatory blood pressure monitoring. The prevalence of hypertension was 15.2% (7/46). The hypertension group had a significant higher BMI z-score at 3 years of age (0.90 ± 1.44 vs − 0.45 ± 1.47, p = 0.045) and a greater proportion of current obesity (42% vs 2.5%, p < 0.01) compared to those in the normotensive group. Multivariate analysis revealed that current obesity was associated with hypertension (OR 34.77, 95%CI 1.814–666.5). Among 36 children with normal office blood pressure, four children (11.1%) had high blood pressure uncovered by ABPM, called “masked hypertension”. Office systolic blood pressure at the 85th percentile was the greatest predictor for masked hypertension with a sensitivity of 75% and a specificity of 81.2%.

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Pacemaker-masked hypertension in a patient with mitral stenosis.

Heart ◽

10.1136/hrt.47.1.98 ◽

1982 ◽

Vol 47 (1) ◽

pp. 98-100

Author(s):

J V Jones

Keyword(s):

Mitral Stenosis ◽

Masked Hypertension

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Masked hypertension in children and adolescents

Current Hypertension Reports ◽

10.1007/s11906-008-0030-1 ◽

2008 ◽

Vol 10 (3) ◽

pp. 165-166 ◽

Cited By ~ 6

Author(s):

Empar Lurbe

Keyword(s):

Children And Adolescents ◽

Masked Hypertension ◽

Hypertension In Children

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Exaggerated Blood Pressure Response to Exercise – A New Portent of Masked Hypertension

Clinical and Experimental Hypertension ◽

10.3109/10641963.2010.503298 ◽

2010 ◽

Vol 32 (8) ◽

pp. 560-568 ◽

Cited By ~ 25

Author(s):

Mehmet Kayrak ◽

Ahmet Bacaksiz ◽

Mehmet Akif Vatankulu ◽

Selim S. Ayhan ◽

Zeynettin Kaya ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Response ◽

Pressure Response ◽

Masked Hypertension ◽

Response To Exercise

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MO501INCREASED ALBUMINURIA RISK IN CHRONIC KIDNEY DISEASE PATIENTS WHOSE WHITE COAT-, MASKED-, AND SUSTAINED HYPERTENSION: SYSTEMATIC REVIEW AND META-ANALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab087.0021 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Boby Pratama Putra ◽

Felix Nugraha Putra

Keyword(s):

Meta Analysis ◽

Blood Pressure Measurement ◽

Target Organ Damage ◽

Random Effect ◽

White Coat ◽

Cochrane Library ◽

White Coat Hypertension ◽

Masked Hypertension ◽

Sustained Hypertension ◽

Standard Mean Difference

Abstract Background and Aims Latest classification of hypertension based on ambulatory blood pressure measurement was normotension (NT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Recent studies suggest that WCHT, MHT, and SHT increase risk of target organ damage, particularly albuminuria, although the results were still inconsistent. Albuminuria is not only the sign of early glomerular damage in CKD patients, but also the signs of hypertension progression and predictors for cardiovascular events mortality. This study aims to compare the albuminuria risk among NT and WCHT, MHT, also SHT in CKD patients. Method We searched the literature comprehensively in online databases of Pubmed, EMBASE, ScienceDirect, and Cochrane Library to include all relevant studies using predefined terms until December 2020. We included studies that analyzed the albuminuria risk and compared the log2 urinary albumin-to-creatinine ratio (ACR) among NT and WCHT, MHT, or SHT in CKD patients. We used the Newcastle-Ottawa Scale for Observational Study checklist for evaluating bias risks. Analysis of the studies was conducted to provide pooled Odds Ratio (OR) for albuminuria risk and standard mean difference (SMD) for log2 ACR comparison with 95% Confidence Interval (CI) with random-effect heterogeneity test. Results We included 7 observational studies met our inclusion criteria. WCHT increases albuminuria risk although not statistically significant (pooled OR = 1.72, 95%CI 0.97 to 3.07, p = 0.06, I2 = 75%), while MHT and SHT significantly increase albuminuria risk with pooled OR respectively 1.62 (95%CI 1.03 to 2.53, p = 0.04, I2 = 82%) and 3.17 (95%CI 1.66 to 6.05, p = 0.0005, I2 = 94%). Controlled hypertension significantly protects CKD patients against albuminuria risk based on log2 ACR comparison with WCHT (SMD = 0.52, 95%CI 0.38 to 0.67, p<0.00001, I2 = 0%), MHT (SMD = 0.34, 95%CI 0.19 to 0.49, p<0.0001, I2 = 39%), and SHT (SMD = 0.63, 95%CI 0.31 to 0.95, p=0.0001, I2 = 76%). Conclusion White coat hypertension, masked hypertension, and sustained hypertension increase albuminuria risks in CKD patients. However, further studies are needed to determine the causality.

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White-coat hypertension and masked hypertension: an update

Italian Journal of Medicine ◽

10.4081/itjm.2015.662 ◽

2015 ◽

Vol 9 (3) ◽

Author(s):

Nathan Artom ◽

Francesco Salvo ◽

Francesca Camardella

Keyword(s):

Cardiovascular Disease ◽

White Coat ◽

White Coat Hypertension ◽

Masked Hypertension ◽

Search Terms ◽

Clinical Consequences ◽

In The Beginning

White coat hypertension and masked hypertension are two conditions with a controversial role in the beginning and the progression of the cardiovascular disease. We focused our attention to the definition, the epidemiology, the pathophysiology and the clinical consequences of these two conditions, with an attention also to the management. This review was based on the papers found on PubMed and MEDLINE up to August 2015. The search terms used were white coat hypertension, masked hypertension in combination with epidemiology, management and pathophysiology.

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