Prevalence and covariates of masked hypertension in ischemic stroke survivors: the Norwegian Stroke in the Young Study.
BACKGROUND
Masked hypertension (MHT) is characterized by normal clinic blood pressure (BP), but elevated ambulatory BP has been associated with a higher prevalence of cardiovascular organ damage.


METHODS
We assessed the prevalence and characteristics of MHT in 298 ischemic stroke patients aged 15-60 years. High-normal office BP was considered present if systolic BP was 130-139 mmHg and/or diastolic BP was 85-89 mmHg. Arterial damage was defined as increased pulse wave velocity measured by applanation tonometry and/or mean common carotid intima-media thickness more than 0.9 mm measured by ultrasound.


RESULTS
MHT was found in 12% of patients. In multivariable logistic regression analysis, MHT patients were characterized by higher BMI [odds ratio (OR) 1.09; 95% confidence interval (CI) 1.03-1.16], high-normal office BP (OR 2.30; 95% CI 1.26-4.21), and higher serum triglycerides (OR 1.32; 95% CI 1.01-1.47, all P<0.05) in the total study population. Compared with normotensive patients, MHT was characterized by a higher prevalence of high-normal office BP (OR 2.05; 95% CI 1.08-3.90), obesity (OR 2.67; 95% CI 1.31-5.47), and arterial damage (OR 2.87; 95% CI 1.46-5.66, all P<0.05). Compared with patients with sustained hypertension, MHT was associated with a lower prevalence of arterial damage (OR 0.48; 95% CI 0.23-0.99, P=0.05) despite a higher prevalence of high-normal office BP and comparable ambulatory BP values.


CONCLUSIONS
Among young and middle-aged ischemic stroke patients, MHT was found in 12% and associated with high-normal office BP, obesity, and more prevalent arterial damage compared with normotensive patients, underscoring the importance of identification of MHT in these patients.
Departments of aHeart Disease bNeurology, Haukeland University Hospital Departments of cClinical Science dClinical Medicine, University of Bergen, Bergen, Norway.
Sahrai
S
Saeed
Ulrike
U
Waje-Andreassen
Annette
A
Fromm
Halvor
H
Øygarden
Halvor
H
Naess
Eva
E
Gerdts
D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D017741:Survivors