Persistence of Masked Hypertension in Chinese Patients

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Abstract

BACKGROUND

Masked hypertension (MH) has 10–15% prevalence and carries risk similar to that of sustained hypertension, but its short-term persistence remains uncertain.

METHODS

Forty-five patients with MH (mean age 52.2 years; 37.8% women) were enrolled in the placebo arm of a randomized clinical trial of Chinese medicine (NCT02156024) and followed up for 4 weeks. MH was office normotension (<140/90mm Hg) and daytime (8:00–18:00) hypertension (≥135/85mm Hg).

RESULTS

At enrolment, office and daytime systolic/diastolic blood pressure (BP) averaged 129.0/80.6mm Hg and 132.9/88.9mm Hg, respectively. Daytime BP thresholds for MH were met in 5 patients (11.1%) for systolic BP, in 25 (55.6%) for diastolic BP and in 15 (33.3%) for both. At follow-up, systolic and diastolic BP had not changed compared with baseline (P ≥ 0.12), except for a 2.1mm Hg decrease in office systolic BP (P = 0.049). MH remained present in 28 patients (62.2%; 95% CI, 48.1–76.3%), whereas 13 (28.9%; 15.7–42.1%) and 4 (8.9%; 0.6–17.2%) converted to normotension (daytime BP <135/85mm Hg) or sustained hypertension (office BP ≥140/90mm Hg), respectively. Substituting daytime by 24-hour BP, using 130/80mm Hg as threshold, produced consistent results. Systolic office BP at baseline independently predicted persistence of MH or progression to sustained hypertension at 4 weeks (odds ratio per 1 − SD increase, 3.49; 95% CI, 1.06–11.2; P = 0.04).

CONCLUSIONS

The information that MH persists over 4 weeks in over two-thirds of this sample of patients should inform future clinical trials and guidelines.

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