Cited by 157Blood Pressure and Hypertension StudiesNon-Invasive Vital Sign MonitoringCardiovascular Health and Disease Prevention

Masked Hypertension Assessed by Ambulatory Blood Pressure Versus Home Blood Pressure Monitoring: Is It the Same Phenomenon?

STERGIOU, G, SALGAMI, E, TZAMOURANIS, D, ROUSSIAS, L·2005·American Journal of Hypertension

Abstract

BACKGROUND: Masked hypertension is defined as normal clinic blood pressure (CBP) and elevated out-of-clinic blood pressure assessed using either self-monitoring of blood pressure (BP) by the patients at home (HBP) or ambulatory BP (ABP) monitoring. This study investigated the level of agreement between ABP and HBP in the diagnosis of masked hypertension. METHODS: Participants referred to an outpatient hypertension clinic had measurements of CBP (two visits), HBP (4 days), and ABP (24 h). The diagnosis of masked hypertension based on HBP (CBP <140/90 mm Hg and HBP > or =135/85) versus ABP (CBP <140/90 and awake ABP > or =135/85) was compared. RESULTS: A total of 438 subjects were included (mean age +/- SD, 51.5 +/- 11.6 years; 59% men and 41% women, 34% treated and 66% untreated). Similar proportions of subjects with masked hypertension were diagnosed by ABP (14.2%) and HBP (11.9%). In both treated and untreated subjects, the masked hypertension phenomenon was as common as the white coat phenomenon. Among 132 subjects with normal CBP, there was disagreement in the diagnosis of masked hypertension between the HBP and the ABP method in 23% of subjects for systolic and 30% for diastolic BP (kappa 0.56). When a 5-mm Hg gray zone for uncertain diagnosis was applied to the diagnostic threshold, the disagreement was reduced to 9% and 6% respectively. CONCLUSIONS: Similar proportions of subjects with masked hypertension are detected by ABP and HBP monitoring. Although disagreement in the diagnosis between the two methods is not uncommon, in the majority of these cases the deviation of the diagnostic BP above the threshold in not clinically important. Both ABP and HBP monitoring appear to be appropriate methods for the detection of masked hypertension.

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Crossref · 10.1016/j.amjhyper.2005.01.003

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Authors
STERGIOU, G., SALGAMI, E., TZAMOURANIS, D., & ROUSSIAS, L.
Affiliations
Sotiria General Hospital (GR)
Corresponding author
STERGIOU, G
Venue
American Journal of Hypertension
Published
2005-06
Volume
18
Issue
6
Pages
772-778
ISSN
0895-7061 (ISSN-L)
OpenAlex
W2084868979
Cited by
157
References
25
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 8 · 2019: 10 · 2018: 5 · 2017: 8 · 2016: 6 · 2015: 10 · 2014: 10 · 2013: 5 · 2012: 7
FWCI
8.68
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
masked hypertension, ambulatory blood pressure monitoring, home blood pressure monitoring, diagnostic agreement, hypertension diagnosis, diagnostic thresholds
MeSH terms
Blood Pressure, Blood Pressure Determination, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Office Visits, Outpatients, Self Care, Sensitivity and Specificity, Blood Pressure Monitoring, Ambulatory

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