title: Alterations in diastolic function in masked hypertension: findings from the masked hypertension study.
abstract: BACKGROUND
  In a prior study of patients with diabetes, diastolic function was similarly impaired in masked hypertension (MHT) and sustained hypertension (SHT). We evaluated whether MHT is associated with impaired diastolic function compared with SHT and sustained normotension (NT) in the general population.
  
  
  METHODS
  From February 2005 to December 2010, 798 participants without a history of cardiovascular disease or treated hypertension, were enrolled in the Masked Hypertension Study. Participants underwent clinic blood pressure (CBP) and 24-hour ambulatory blood pressure (ABP) measurements. A 2-dimensional Doppler echocardiogram was performed to evaluate diastolic function,s cardiac structure, volume, and systolic function. The 9 CBPs obtained across 3 clinic visits and awake ABP measurements were averaged. Clinic hypertension was defined as systolic/diastolic blood pressure (SBP/DBP) ≥ 140/90 mmHg. Ambulatory hypertension was defined as awake SBP/DBP ≥ 135/85mm Hg. MHT was defined as having ambulatory but not clinic hypertension. White-coat hypertensives (n = 8) were excluded from the analysis.
  
  
  RESULTS
  Of the 790 participants, 116 (14.7%) participants had MHT, 37 (4.7%) participants had SHT, and 637 (80.6%) participants had NT. After age, sex, race/ethnicity, and body mass index adjustment, compared with NT, E'-velocities were significantly lower in MHT (P < 0.01) and SHT (P < 0.05), and E/E' ratios were significantly higher MHT (P < 0.05) and SHT (P < 0.05). These associations were independent of left ventricular mass. Diastolic function parameters did not significantly differ between MHT and SHT.
  
  
  CONCLUSIONS
  Diastolic function was impaired in MHT compared with NT independent of changes in left ventricular mass.
authors: Department of Medicine, Columbia University Medical Center, New York, New York, USA.
authors: Yukiko
authors: Y
authors: Oe
authors: Daichi
authors: D
authors: Shimbo
authors: Joji
authors: J
authors: Ishikawa
authors: Kazue
authors: K
authors: Okajima
authors: Takuya
authors: T
authors: Hasegawa
authors: Keith M
authors: KM
authors: Diaz
authors: Paul
authors: P
authors: Muntner
authors: Shunichi
authors: S
authors: Homma
authors: Joseph E
authors: JE
authors: Schwartz
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D015992:Body Mass Index; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left
keywords: ambulatory blood pressure monitoring; blood pressure; echocardiography; hypertension.