Key result
Masked hypertension was associated with increased arterial stiffness (c-f PWV 11.28 m/s vs 9.91 m/s in normotension), with an optimal office BP cutoff of 130/80 mm Hg for diagnosis.
Why the study?
It was unknown whether masked hypertension and white coat hypertension are related to increased arterial stiffness, and optimal office blood pressure cutoffs for their diagnosis were needed.
Cross-Sectional (n=542)
Absolute Event Rate: 11.28% vs 9.91%
Masked hypertension is associated with increased arterial stiffness compared to normotension, and an office BP cutoff of 130/80 mm Hg provides the best sensitivity and specificity for its diagnosis.
Office BP cutoffs may refine MHT/WCHT detection in untreated adults; leaves open arterial stiffness associations.
The aim of this study was to determine whether masked hypertension (MHT) and white coat hypertension (WCHT) could be related to increased arterial stiffness and to identify the best office cutoff values of office BP for the diagnosis of MHT and WCHT. A total of 542 consecutive patients (50.2% male, age 42.5 ± 26.2 years) were included in the study. Patients were never treated before for hypertension. Patients were classified as true normotensives (44%), true hypertensives (30%), WC hypertensives (19%), and masked hypertensives (7%). Carotid-femoral pulse wave velocity (c-f PWV) was 9.91 ± 0.20 m/s in true normotension, 10.26 ± 0.27 m/s in WCHT, 11.28 ± 0.47 m/s in MHT, and 11.86 ± 0.23 m/s in true hypertension after adjustment for age and sex. Decision limits yielding 65% sensitivity were 130 mm Hg for office systolic BP with 72% specificity for the diagnosis of MHT. The optimal cutoff value of 80 mm Hg for office diastolic BP provides 60% sensitivity and 68% specificity. Decision limits yielding 63% sensitivity were 150 mm Hg for office systolic BP with 72% specificity for the diagnosis of WCHT. The optimal cutoff value of 95 mm Hg for office diastolic BP provides 75% sensitivity and 51% specificity. The presence of MHT should be taken into account when increased c-f PWV is detected in the absence of office hypertension. The optimal office BP of 130/80 mm Hg provides the best sensitivity and specificity for the diagnosis of MHT. As regards the diagnosis of WCHT, the cutoff value of 150/95 mm Hg seems to provide the best option.
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Antza et al. (2019) conducted a cross-sectional in Hypertension (n=542). Masked hypertension vs. True normotension was evaluated on Carotid-femoral pulse wave velocity (c-f PWV). Masked hypertension was associated with increased arterial stiffness (c-f PWV 11.28 m/s vs 9.91 m/s in normotension), with an optimal office BP cutoff of 130/80 mm Hg for diagnosis.
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