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Prognosis of White-Coat and Masked Hypertension: International Database of Home Blood Pressure in Relation to Cardiovascular Outcome

Hypertension (Dallas, Tex. 1979), 2014-04, Vol.63 (4), p.675-682 [Peer Reviewed Journal]

2014 American Heart Association, Inc ;2015 INIST-CNRS ;ISSN: 0194-911X ;EISSN: 1524-4563 ;DOI: 10.1161/HYPERTENSIONAHA.113.02741 ;PMID: 24420553 ;CODEN: HPRTDN

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Title:
Prognosis of White-Coat and Masked Hypertension: International Database of Home Blood Pressure in Relation to Cardiovascular Outcome
Author: Stergiou, George S ; Asayama, Kei ; Thijs, Lutgarde ; Kollias, Anastasios ; Niiranen, Teemu J ; Hozawa, Atsushi ; Boggia, José ; Johansson, Jouni K ; Ohkubo, Takayoshi ; Tsuji, Ichiro ; Jula, Antti M ; Imai, Yutaka ; Staessen, Jan A
Subjects: Adult ; Aged ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Blood Pressure Monitoring, Ambulatory ; Cardiology. Vascular system ; Cardiovascular Diseases - epidemiology ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Male ; Masked Hypertension - diagnosis ; Masked Hypertension - drug therapy ; Masked Hypertension - epidemiology ; Medical sciences ; Middle Aged ; Prevalence ; Prognosis ; Risk Factors ; Treatment Outcome ; White Coat Hypertension - diagnosis ; White Coat Hypertension - drug therapy ; White Coat Hypertension - epidemiology
Is Part Of: Hypertension (Dallas, Tex. 1979), 2014-04, Vol.63 (4), p.675-682
Description: Home blood pressure monitoring is useful in detecting white-coat and masked hypertension and is recommended for patients with suspected or treated hypertension. The prognostic significance of white-coat and masked hypertension detected by home measurement was investigated in 6458 participants from 5 populations enrolled in the International Database of HOme blood pressure in relation to Cardiovascular Outcomes. During a median follow-up of 8.3 years, 714 fatal plus nonfatal cardiovascular events occurred. Among untreated subjects (n=5007), cardiovascular risk was higher in those with white-coat hypertension (adjusted hazard ratio 1.42; 95% CI [1.06–1.91]; P=0.02), masked hypertension (1.55; 95% CI [1.12–2.14]; P<0.01) and sustained hypertension (2.13; 95% CI [1.66–2.73]; P<0.0001) compared with normotensive subjects. Among treated patients (n=1451), the cardiovascular risk did not differ between those with high office and low home blood pressure (white-coat) and treated controlled subjects (low office and home blood pressure; 1.16; 95% CI [0.79–1.72]; P=0.45). However, treated subjects with masked hypertension (low office and high home blood pressure; 1.76; 95% CI [1.23–2.53]; P=0.002) and uncontrolled hypertension (high office and home blood pressure; 1.40; 95% CI [1.02–1.94]; P=0.04) had higher cardiovascular risk than treated controlled patients. In conclusion, white-coat hypertension assessed by home measurements is a cardiovascular risk factor in untreated but not in treated subjects probably because the latter receive effective treatment on the basis of their elevated office blood pressure. In contrast, masked uncontrolled hypertension is associated with increased cardiovascular risk in both untreated and treated patients, who are probably undertreated because of their low office blood pressure.
Publisher: Hagerstown, MD: American Heart Association, Inc
Language: English
Identifier: ISSN: 0194-911X
EISSN: 1524-4563
DOI: 10.1161/HYPERTENSIONAHA.113.02741
PMID: 24420553
CODEN: HPRTDN
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE

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Prognosis of White-Coat and Masked Hypertension: International Database of Home Blood Pressure in Relation to Cardiovascular Outcome

2014 American Heart Association, Inc ;2015 INIST-CNRS ;ISSN: 0194-911X ;EISSN: 1524-4563 ;DOI: 10.1161/HYPERTENSIONAHA.113.02741 ;PMID: 24420553 ;CODEN: HPRTDN

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