title: Masked hypertension defined by home blood pressure monitoring is associated with impaired flow-mediated vasodilatation in patients with cardiovascular risk factors.
abstract: The relationships between home blood pressure (BP), masked hypertension defined by home BP, and integrated flow-mediated vasodilation (FMD) response remain unclear. The authors enrolled 257 patients (mean age, 63.5 years; 51% men) who had at least one cardiovascular risk factor. FMD of the brachial artery was measured with a semiautomatic edge-detection algorithm. The integrated FMD response was calculated as the area under the dilation curve during 120 seconds after deflation (FMD-AUC120) and the FMD magnitude as the percentage change in peak diameter (ΔFMD). Masked hypertension was defined by office BP <140/90 mm Hg and home BP ≥135 mm Hg and/or 85 mm Hg. Home systolic BP was inversely correlated with FMD-AUC120 and ΔFMD (FMD-AUC120: r=-.23, P<.001; ΔFMD: r=-.13, P=.041), and office systolic BP was inversely associated with FMD-AUC120 (r=-.16, P=.011), but not with ΔFMD. After adjusting for covariates, home systolic BP (β=-.27, P=.003), but not office BP, was inversely associated with FMD-AUC120, whereas ΔFMD was not associated with office or home systolic BP. FMD-AUC120 was significantly lower in patients with masked hypertension compared with those with normotension (7.7±6.7 vs 11.5±8.8 mm × s, P=.048). Home systolic BP and masked hypertension defined by home BP were associated with a decrease in FMD-AUC120.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kabutoya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.forename: Yukiyo
authors.initials: Y
authors.lastname: Ogata
authors.forename: Kazuo
authors.initials: K
authors.lastname: Eguchi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
mesh_terms: D000368:Aged; D000465:Algorithms; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D001916:Brachial Artery / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D009819:Office Visits; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D013599:Systole / Q000502:physiology; D014664:Vasodilation / Q000502:physiology*
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