Masked hypertension (RR 2.28; 95% CI 1.1-4.7) and true resistant hypertension (RR 2.94; 95% CI 1.02-8.41) significantly increased the risk of cardiovascular events versus responder hypertension.
Cohort (n=742)
Do masked, false resistant, and true resistant hypertension phenotypes increase the risk of cardiovascular events compared to responder hypertension in treated hypertensive patients?
Masked and true resistant hypertension are associated with a significantly higher risk of cardiovascular events compared to responder hypertension, highlighting the prognostic value of ambulatory blood pressure monitoring.
Effect estimate: RR 2.28 (95% CI 1.1-4.7)
Absolute Event Rate: 2.42% vs 0.87%
p-value: p=< .05
BACKGROUND: The aim of this study was to evaluate the cardiovascular outcome in apparently responder hypertensive patients with responder and masked hypertension, and in apparently resistant hypertensive patients with false and true resistant hypertension. METHODS: The occurrence of fatal and nonfatal cardiovascular events was evaluated in 340 patients with responder hypertension (clinic blood pressure BP 135 or 85 mm Hg), 146 with false resistant hypertension (clinic BP >or=140 or 90 mm Hg and daytime BP or=140 or 90 mm Hg and daytime BP >135 or 85 mm Hg). RESULTS: During follow-up period (4.98 +/- 2.9 years), the event-rate per 100 patient-years was 0.87, 2.42, 1.2, and 4.1 in patients with responder, masked, false resistant, and true resistant hypertension, respectively. After adjustment for several covariates, including clinic BP (forced into the model), Cox regression analysis showed that cardiovascular risk was significantly higher in masked hypertension (masked versus responder hypertension, relative risk RR 2.28, 95% confidence interval CI 1.1-4.7, P < .05) and in true resistant hypertension (true resistant versus responder hypertension, RR 2.94, 95% CI 1.02-8.41, P < .05), whereas there was no significant difference between false resistant and responder hypertension. CONCLUSIONS: This study shows that patients with masked hypertension are at higher risk than those with responder hypertension, and that those with false resistant hypertension are at lower risk than those with true resistant hypertension. Ambulatory BP monitoring should be performed in treated hypertensive patients to obtain a better prognostic stratification.
PIERDOMENICO et al. (Tue,) conducted a cohort in Treated hypertension (n=742). Masked hypertension vs. Responder hypertension was evaluated on Fatal and nonfatal cardiovascular events (RR 2.28, 95% CI 1.1-4.7, p=< .05). Masked hypertension (RR 2.28; 95% CI 1.1-4.7) and true resistant hypertension (RR 2.94; 95% CI 1.02-8.41) significantly increased the risk of cardiovascular events versus responder hypertension.