title: Predictors of masked hypertension among treated hypertensive patients: an interesting association with orthostatic hypertension.
abstract: BACKGROUND
  Masked hypertension (MH) entails an increased cardiovascular risk. Therefore, it is important to identify those individuals who would benefit the most from out-of-office blood pressure (BP) measurement. We sought to determine the prevalence and identify predictors of MH among adult hypertensive patients under treatment.
  
  
  METHODS
  Treated hypertensive patients aged ≥ 18 years underwent office (duplicate sitting and standing BP in 1 visit) and home BP measurements (duplicate measurements for 4 days in the morning, afternoon, and evening; at least 16 measurements) and completed a questionnaire regarding risk factors and history of cardiovascular disease. MH was defined as normal office BP (<140/90mm Hg) with elevated home BP (≥135/85mm Hg, average of all readings discarding first day measurements). Patients with a systolic BP rise upon standing ≥5mm Hg were considered to have orthostatic hypertension (OHT). Variables indentified as relevant predictors of MH were entered into a multivariable logistic regression analysis model.
  
  
  RESULTS
  Three hundred and four patients were included (mean age = 66.7 ±13.8; 67.4% women). The prevalence of MH in the whole population was 12.4% and was 20.9% among patients with office-controlled hypertension. Factors independently associated with MH were age (odds ratio (OR) = 1.08, 95% confidence interval (CI) = 1.03-1.14), high-normal office systolic BP (OR = 5.61, 95% CI = 1.39-22.57), history of peripheral artery disease (PAD) (OR = 8.83, 95% CI = 1.5-51.84), moderate alcohol consumption (OR = 0.08, 95% CI = 0.01-0.73), and OHT (OR = 3.65, 95% CI = 1.27 to 10.51).
  
  
  CONCLUSIONS
  Easily measurable parameters such as age, office systolic BP, history of PAD, and OHT may help to detect a population at risk of MH that would benefit from home BP monitoring.
authors.affiliation: Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. jessica.barochiner@hospitalitaliano.org.ar
authors.forename: Jessica
authors.initials: J
authors.lastname: Barochiner
authors.forename: Paula E
authors.initials: PE
authors.lastname: Cuffaro
authors.forename: Lucas S
authors.initials: LS
authors.lastname: Aparicio
authors.forename: José
authors.initials: J
authors.lastname: Alfie
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Rada
authors.forename: Margarita S
authors.initials: MS
authors.lastname: Morales
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Galarza
authors.forename: Gabriel D
authors.initials: GD
authors.lastname: Waisman
mesh_terms: D000368:Aged; D001118:Argentina / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002940:Circadian Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D008297:Male; D059468:Masked Hypertension / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D054971:Orthostatic Intolerance / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011187:Posture; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: blood pressure; home blood pressure; hypertension; masked hypertension; orthostatic hypertension; predictors.