Masked uncontrolled hypertension was associated with a significantly higher risk of cardiovascular events compared to controlled hypertension (HR 1.60; 95% CI 1.12-2.29; P=0.01).
Cohort (n=1,191)
Does masked or white coat uncontrolled hypertension increase the risk of cardiovascular events in elderly treated hypertensive patients compared to controlled hypertension?
In elderly treated hypertensive patients, masked uncontrolled hypertension is associated with a significantly higher cardiovascular risk compared to controlled hypertension, whereas white coat uncontrolled hypertension is not.
Effect estimate: HR 1.60 (95% CI 1.12-2.29)
p-value: p=0.01
BACKGROUND: Prognosis of masked and white coat uncontrolled hypertension (MUCH and WCUCH, respectively) detected by ambulatory blood pressure (BP) monitoring is incompletely clear in elderly treated hypertensive patients. We evaluated prognosis of MUCH and WCUCH identified by ambulatory BP monitoring in this setting. METHODS: The occurrence of a composite endpoint was evaluated in 1,191 elderly treated hypertensive patients. Controlled hypertension (CH) was defined as clinic BP <140/90 mm Hg and 24-hour BP <130/80 mm Hg, MUCH as clinic BP <140/90 mm Hg and 24-hour BP ≥130 and/or ≥80 mm Hg, WCUCH as clinic BP ≥140 and/or ≥90 mm Hg and 24-hour BP <130/80 mm Hg and sustained uncontrolled hypertension (SUCH) as clinic BP ≥140 and/or ≥90 mm Hg and 24-hour BP ≥130 and/or ≥80 mm Hg. RESULTS: MUCH was identified in 142 patients (12% of all the population, 34% of those with normal clinic BP) and WCUCH in 230 patients (19% of all the population, 30% of those with high clinic BP). During the follow-up (9.1 ± 4.9 years, range 0.4-20 years), 392 events occurred. After adjustment for various covariates, patients with MUCH (hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.12-2.29, P = 0.01) and SUCH (HR 1.81, 95% CI, 1.35-2.42, P < 0.001) had significantly higher cardiovascular risk than those with CH, whereas those with WCUCH (HR 1.09, 95% CI, 0.74-1.60, P = 0.66) had not significantly higher risk. CONCLUSIONS: In elderly treated hypertensive patients evaluated by ambulatory BP monitoring, compared to individuals with CH, those with MUCH have significantly higher risk and those with WCUCH have slightly and not significantly higher risk.
Pierdomenico et al. (Fri,) conducted a cohort in Treated hypertension (n=1,191). Masked uncontrolled hypertension (MUCH) vs. Controlled hypertension (CH) was evaluated on Composite endpoint (HR 1.60, 95% CI 1.12-2.29, p=0.01). Masked uncontrolled hypertension was associated with a significantly higher risk of cardiovascular events compared to controlled hypertension (HR 1.60; 95% CI 1.12-2.29; P=0.01).