Finding Trouble Under the Disguise
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Masked hypertension is a clinical condition in which a patient has a normal blood pressure in the clinic but an elevated blood pressure outside the office setting. It has been previously suggested with large population cohort studies that 15% to 30% of adults have masked hypertension and that this is associated with an increased risk of cardiovascular morbidity and mortality compared with sustained normotension or even white-coat hypertension.1–3 Only recently has the importance of masked hypertension been fully appreciated. The diagnosis of white-coat hypertension is often a relief to patients and physicians because it illustrates that things are usually better than they first seem and less needs to be done. However, seeking the presence of masked hypertension is a less happy task because even the validity of a seemingly normal office blood pressure is called into question.
See Article by Anstey et al
A topic of debate has been who should be screened for masked hypertension. An increased prevalence of masked hypertension has been associated with higher clinic blood pressures, older age, male sex, smoking, diabetes mellitus, obesity, and use of an antihypertensive medication.1 A prior analysis using data from the Jackson Heart Study—a prospective cohort of blacks—demonstrated a …