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- Title
Predictors of Masked Hypertension Among Treated Hypertensive Patients: An Interesting Association With Orthostatic Hypertension.
- Authors
Barochiner, Jessica; Cuffaro, Paula E.; Aparicio, Lucas S.; Alfie, José; Rada, Marcelo A.; Morales, Margarita S.; Galarza, Carlos R.; Waisman, Gabriel D.
- Abstract
BACKGROUND Masked hypertension (MH) entails an increased cardiovascular risk. Therefore, it is important to identify those individuals who would benefit the most from out-of-office blood pressure (BP) measurement. We sought to determine the prevalence and identify predictors of MH among adult hypertensive patients under treatment. METHODS Treated hypertensive patients aged ≥ 18 years underwent office (duplicate sitting and standing BP in 1 visit) and home BP measurements (duplicate measurements for 4 days in the morning, afternoon, and evening; at least 16 measurements) and completed a questionnaire regarding risk factors and history of cardiovascular disease. MH was defined as normal office BP (<140/90mm Hg) with elevated home BP (≥135/85mm Hg, average of all readings discarding first day measurements). Patients with a systolic BP rise upon standing ≥5mm Hg were considered to have orthostatic hypertension (OHT). Variables indentified as relevant predictors of MH were entered into a multivariable logistic regression analysis model. RESULTS Three hundred and four patients were included (mean age = 66.7 ±13.8; 67.4% women). The prevalence of MH in the whole population was 12.4% and was 20.9% among patients with office-controlled hypertension. Factors independently associated with MH were age (odds ratio (OR) = 1.08, 95% confidence interval (CI) = 1.03–1.14), high-normal office systolic BP (OR = 5.61, 95% CI = 1.39–22.57), history of peripheral artery disease (PAD) (OR = 8.83, 95% CI = 1.5–51.84), moderate alcohol consumption (OR = 0.08, 95% CI = 0.01–0.73), and OHT (OR = 3.65, 95% CI = 1.27 to 10.51). CONCLUSIONS Easily measurable parameters such as age, office systolic BP, history of PAD, and OHT may help to detect a population at risk of MH that would benefit from home BP monitoring.
- Subjects
HYPERTENSION; THERAPEUTICS; CARDIOVASCULAR diseases risk factors; BLOOD pressure measurement; ORTHOSTATIC hypotension; PHYSIOLOGICAL effects of alcohol
- Publication
American Journal of Hypertension, 2013, Vol 26, Issue 7, p872
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpt036