Key result
Recent type 2 diabetes linked to ~2.3-fold higher prevalence of masked hypertension.
Why the study?
Accurate characterization of blood pressure phenotypes is essential for cardiovascular risk assessment, particularly among recently diagnosed T2DM patients, but data in Black Africans using multiple BP assessment methods were lacking.
Does out-of-office blood pressure assessment using ABPM or HBPM improve the detection of masked hypertension compared to standard office or automated office measurements in Black African adults with and without recently diagnosed type 2 diabetes mellitus?
Case-Control (n=302)
Yes
Does out-of-office blood pressure assessment using ABPM or HBPM improve the detection of masked hypertension compared to standard office or automated office measurements in Black African adults with and without recently diagnosed type 2 diabetes mellitus?
Absolute Event Rate: 23.2% vs 9.9%
p-value: p=0.004
In patients with recently diagnosed T2DM, standard office and home blood pressure monitoring frequently fail to identify masked hypertension, highlighting the necessity of 24-hour ambulatory monitoring to detect abnormal nocturnal blood pressure patterns.
Accurate characterization of blood pressure (BP) phenotypes is essential for cardiovascular risk assessment, particularly among type 2 diabetes mellitus (T2DM) patients. We aimed to evaluate the prevalence of different BP phenotypes using multiple BP assessment methods, in Black Africans, with and without T2DM. Recently diagnosed T2DM patients (n = 151) and age- and sex- matched controls (1:1) without T2DM had their BP assessed using standard office BP measurement (OBPM), unattended automated office BP measurement (u-AOBP), 24 h ambulatory BP monitoring (ABPM), and home BP monitoring (HBPM). Four BP phenotypes were defined, combining OBPM with each of the remaining methods: normotension, white-coat, masked, and sustained hypertension. Using OBPM + ABPM, T2DM patients were less often classified as normotensive (32.5% vs. 48.3%) and more often as having masked hypertension (23.2% vs. 9.9%) than controls (p = 0.004). Both OBPM + HBPM and OBPM + u-AOBP underestimated masked hypertension and overestimated with-coat hypertension. When compared with OBPM + ABPM, concordance in the classification of participants into four phenotypes (κ, 95%CI) was higher for OBPM + HBPM (T2DM: 0.62, 0.52 - 0.71; controls: 0.70, 0.60-0.80) than for OBPM + u-AOBP (T2DM: 0.51, 0.40-0.61; controls: 0.61, 0.50-0.72) and lower among participants with T2DM. Recently diagnosed T2DM patients showed a higher prevalence of masked hypertension than participants without T2DM. When combined with OBPM, HBPM and u-AOBP failed to identify a large proportion of patients with masked hypertension and overestimated white-coat hypertensions, highlighting the need to incorporate ABPM into evaluation protocols.
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Govo et al. (2026) conducted a case-control in Type 2 Diabetes Mellitus (n=302). Type 2 Diabetes Mellitus vs. Matched controls without T2DM was evaluated on Prevalence of masked hypertension defined by OBPM + ABPM (p=0.004). Recently diagnosed type 2 diabetes patients had a significantly higher prevalence of masked hypertension compared to matched controls (23.2% vs. 9.9%, p=0.004) when evaluated by combined office and ambulatory blood pressure monitoring.
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