The relationship of masked hypertension with autonomic dysfunction and cardiometabolic parameters: a case-control study.

OBJECTIVE: Masked hypertension (MH) is associated with cardiovascular events and mortality. Data on the association between exaggerated blood pressure response (EBPR) to exercise, heart rate recovery (HRR), which are indicators of autonomic dysfunction, and MH are lacking. This study aimed at evaluating the association between EBPR, HRR, and MH. PATIENTS AND METHODS: Between January 2020 and January 2021, 130 MH (57 male, median age = 52.8 years) and 60 healthy (28 male, median age = 40.8 years) subjects were included in this single-center, case-control, and cross-sectional study. Office blood pressure measurement, 24-hour ambulatory blood pressure monitoring, treadmill test, echocardiography, and specific biochemical parameters were evaluated. RESULTS: The frequency of blunted HRR (73 subjects, 56.2%) and EBPR (40 subjects, 30.8%) were significantly higher in patients with MH (p < 0.001). Patients with MH had higher serum uric acid levels and frequency of hyperlipidemia (p < 0.05). Diameters of the left atrium (LA), aortic root, and ascending aorta were significantly higher in MH patients (p < 0.05). Thirty-two (24.6%) patients with MH had left ventricular hypertrophy and 33 (25.4%) had diastolic dysfunction (p < 0.001). Multivariate analysis identified the presence of blunted HRR as an independent predictor factor of MH as well as smoking, hyperlipidemia, GFR, LA diameter, and aortic root diameter were other independent factors. CONCLUSIONS: The frequency of blunted HRR and EBPR were significantly higher in the MH group compared to the control group, suggesting a close relationship between MH and autonomic dysfunction.