July 30, 2007Journal of Clinical HypertensionOpen Access

Masked Hypertension in Diabetes Mellitus: A Potential Risk

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Why the study?

Does masked hypertension increase the risk of microvascular and macrovascular end organ damage in clinically normotensive patients with type 2 diabetes?

Population

81 Japanese patients with type 2 diabetes whose clinic blood pressure was <140/90 mm Hg. Excluded patients…

Comparison

Masked hypertension, defined as awake ambulatory… vs Normotension, defined as both clinic blood…

Design

Cohort, MR images were randomly stored and interpreted by reviewers blinded to…

Authors

JIJoji IshikawaTokyo Metropolitan Institute of Gerontology SHSatoshi HoshidePreventive Cardiology TPThomas G. PickeringUniversity of Southern California

Discussion

Member takes

Implication

MHT was associated with greater organ damage in normotensive diabetics; leaves open whether ambulatory BP monitoring improves risk stratification.

Structured PICO

Does masked hypertension increase the risk of microvascular and macrovascular end organ damage in clinically normotensive patients with type 2 diabetes?

Population

81 Japanese patients with type 2 diabetes (mean age 63.5 years, 46 men and 35 women) whose clinic blood pressure was <140/90 mm Hg. Excluded patients with type 1 diabetes, renal dysfunction (serum creatinine >1.2 mg/dL), hepatic damage, secondary diabetes, ischemic heart disease, congestive heart failure, arrhythmia, stroke, or other severe concomitant diseases.

Intervention

Masked hypertension (MHT), defined as awake ambulatory blood pressure ≥135/85 mm Hg and clinic blood pressure <140/90 mm Hg

Comparator

Normotension, defined as both clinic blood pressure <140/90 mm Hg and awake ambulatory blood pressure <135/85 mm Hg

Outcome

Prevalence of silent cerebral infarcts (SCIs), increased left ventricular mass index (LVMI), and albuminuriasurrogate

Masked hypertension is highly prevalent in clinically normotensive patients with type 2 diabetes and is associated with increased silent cerebral infarcts and albuminuria, suggesting the need for out-of-office blood pressure monitoring.

Limitations

Small number of normotensive patients
Arbitrary cutoffs for clinic and awake blood pressure
Heterogeneous population including both treated and untreated patients
Cross-sectional design limits analysis of prior treatment effects

Cite This Study

Ishikawa et al. (2007) studied this question.

synapsesocial.com/papers/6a7dc82ee5d85d18548c9bde https://doi.org/10.1111/j.1524-6175.2007.06610.x

Topics

Hypertension management

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Implication

MHT was associated with greater organ damage in normotensive diabetics; leaves open whether ambulatory BP monitoring improves risk stratification.

Masked Hypertension in Diabetes Mellitus: A Potential Risk

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Masked Hypertension in Diabetes Mellitus: A Potential Risk

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider