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Is it Practical to Search for Masked Hypertension?

Abstract

Marjo-Riitta Hänninen

Masked hypertension refers to a condition with normal office and elevated home or ambulatory BP without antihypertensive medication. It is a common phenomenon in a general population with a prevalence of 8-17%. However, the persistence of masked hypertension is limited, and agreement between home and ambulatory BP is only moderate. Different definitions for masked hypertension are still used, for example, elevated 24-hour, daytime, working or nighttime BP. Masked hypertension has been associated with high-normal office BP, obesity, male gender, and metabolic or lifestyle risk factors but these findings have not always been consistent. Masked hypertension has also been related to target organ damage, most commonly left ventricular hypertrophy. The cardiovascular risk associated with masked hypertension in a general population is still controversial and may, in part, be related to other concomitant cardiovascular risk factors. There is no evidence on the treatment and cost-effectiveness of masked hypertension. Implementation of out-of-office BP measurement and identification of masked hypertension in clinical practice requires interaction with general practitioners. Further studies need to map and bridge the gaps between experts´ recommendations and needs of general practitioners.