Many papers have reported that patients with masked hypertension had the progression of preclinical target organ damage comparable to sustained hypertension. However, it is not clear yet whether controlling blood pressure (BP) would improve organ damage in masked hypertension.Design and Method:
We use data available from a current study of BP in two clinical studies (JMS-1 and J-TOP study), which enrolled hypertensives with self-measured home systolic BP (SBP) more than 135mmHg and titrated antihypertensive drug to achieve a target home SBP less than 135 mmHg during 6 months.Results:
In masked hypertension group (>135/85 mmHg in morning BP and <140/90 mmHg in clinic BP: n = 135), morning home SBP at 6 months follow up significantly reduced compared with baseline (147.9 ± 10.9 vs. 136.1 ± 13.4 mmHg, P < 0.001), while this association was not found in clinic SBP (133.2 ± 7.1 vs, 132.9 ± 15.1 mmHg, P = 0.81). In sustained hypertension group (>135/85 mmHg in morning SBP and >140/90 mmHg in clinic BP: n = 585), both morning SBP (154.3 ± 13.5 vs. 137.7 ± 14.1 mmHg, P < 0.001) and clinic SBP (159.4 ± 14.9 vs. 143.5 ± 19.8 mmHg, P < 0.001) significantly reduced compared with baseline. Left ventricular mass index (LVMI) assessed by echocardiography and urinary albumin creatinine ratio (UACR) as preclinical target organ damage significantly reduced at 6 months follow up in masked hypertension (mean LVMI, 126.2 vs. 113.3 g/m2; P = 0.001, median UACR, 17.2 vs. 13.0 mg/gxcre; P < 0.001), and sustained hypertension group (mean LVMI, 126.5 vs. 118.2 g/m2; P < 0.001, median UACR, 22.8 vs. 12.8 mg/gxcre; P < 0.001).Conclusions:
In masked hypertension, home BP-guided antihypertensive treatment improved home BP control and preclinical target organ damage.