Diagnosis of masked uncontrolled nocturnal hypertension using ABPM yielded a significantly higher prevalence compared to HBPM (36.5% vs. 15.7%; p<0.01), indicating poor diagnostic agreement.
Cross-Sectional (n=76)
Does HBPM agree with ABPM in diagnosing masked uncontrolled nocturnal hypertension?
There is poor agreement between ABPM and HBPM in diagnosing masked uncontrolled nocturnal hypertension, with ABPM potentially overdiagnosing the condition.
Absolute Event Rate: 36.5% vs 15.7%
p-value: p=<0.01
Objective: Masked nocturnal hypertension (MNH) diagnosed with HBPM was more strongly associated with CV outcomes than MNH based on ABPM. A fair reproducibility of MH assessed through ABPM and HBPM was reported. Our study aimed to examine the prevalence of masked uncontrolled nocturnal hypertension (MUCNH), assess the diagnostic agreement between MUCNH detected by ABPM and HBPM, and analyse the characteristics of true MUCNH. Design and method: In this pilot phase, we analysed data from 76 of 112 subjects who had office BP measurements, 7-day/night HBPM (Microlife night BPWatch- twice each morning and evening), and ABPM (Mobilograph IAM). Exclusion criteria: pregnancy, lactation, resistant hypertension, CKD stage 5, IM/stroke 6 months before the study, less than 80% ABPM records, less than 40 daytime and 20 nighttime HBP readings. We used ESH cut off values for nighttime BP. Subjects were divided group A: MUCNH only on ABPM; and group B: MUCNH on both ABPM and HBPM (true” MUCNH). Results: The prevalence of MUCNH based on ABPM was significantly higher than prevalence based on HBPM and true MUCNH (36.5%vs.15.7%vs.10.5%, respectively; p 3G stage, less smokers, had lower values of fasting blood glucose, triglycerides, and higher values of HDL-cholesterol, and lower values of albumin-to-creatinine ratio (ACR) (17.7 vs.65.6;p<0.05), and lower total CV risk calculated with SCORE2 (11.5 vs.15.6;p<0.05) and PREVENT 10 years and 30 years equations (8.7 vs.18, and 24.6 vs.32.7, respectively). Conclusions: We found poor agreement in diagnosing MUCNH with HBPM or ABPM. “True MUCHN” had more CKD, diabetes and higher values of several metabolic parameters, and more TOD (ACR), and higher global CV risk. Our results might indicate that ABPM over diagnosed MUCNH. Nocturnal HBPM can be included in evaluation of subjects with the risk for MH where an ABPM/HBPM-based strategy should be considered. Result of our pilot phase will be tested in the whole group.
Jelaković et al. (2026) conducted a cross-sectional in Masked uncontrolled nocturnal hypertension (n=76). Ambulatory Blood Pressure Monitoring (ABPM) vs. Home Blood Pressure Monitoring (HBPM) was evaluated on Prevalence of masked uncontrolled nocturnal hypertension (MUCNH) (p=<0.01). Diagnosis of masked uncontrolled nocturnal hypertension using ABPM yielded a significantly higher prevalence compared to HBPM (36.5% vs. 15.7%; p<0.01), indicating poor diagnostic agreement.