A1 Refereed original research article in a scientific journal
Target organ damage and masked hypertension in the general population: the Finn-Home study
Authors: Hanninen MRA, Niiranen TJ, Puukka PJ, Kesaniemi YA, Kahonen M, Jula AM
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Publication year: 2013
Journal: Journal of Hypertension
Journal name in source: JOURNAL OF HYPERTENSION
Journal acronym: J HYPERTENS
Volume: 31
Issue: 6
First page : 1136
Last page: 1143
Number of pages: 8
ISSN: 0263-6352
DOI: https://doi.org/10.1097/HJH.0b013e32835fa5dc
Abstract
Background: The relation of masked hypertension to target organ damage has very seldom been investigated in a general population.Methods: An unselected population cohort (n = 1989 of which 1540 were not treated for hypertension) underwent office (duplicate measurements on one visit by a nurse) and home (duplicate measurements on 7 days) blood pressure (BP) measurements and evaluation of electrocardiographic left ventricular hypertrophy (ECG-LVH, n = 1989/1540), carotid intima-media thickness (cIMT, n = 758/592), and pulse wave velocity (PWV, n = 237/158). ECG-LVH was diagnosed using Cornell voltage criteria. PWV was measured using whole-body impedance cardiography. Masked hypertension was defined as office BP less than 140/90mmHg with home BP at least 135/85mmHg and white-coat hypertension as office BP at least 140/90mmHg and home BP less than 135/85mmHg.Results: Masked and sustained hypertensive individuals had significantly higher age-adjusted and sex-adjusted Cornell voltage, cIMT, and PWV than normotensive individuals. White-coat hypertensive patients had higher age-adjusted and sex-adjusted Cornell voltage than normotensive individuals but significantly lower Cornell voltage and PWV than sustained hypertensive patients. The differences in Cornell voltage and PWV remained significant after adjustment for confounding factors. However, all differences became nonsignificant after adjustment for systolic home BP.Conclusion: Masked and sustained hypertension is accompanied by increased risk for hypertensive target organ damage, whereas white-coat hypertension seems to be a more benign phenomenon.
Background: The relation of masked hypertension to target organ damage has very seldom been investigated in a general population.Methods: An unselected population cohort (n = 1989 of which 1540 were not treated for hypertension) underwent office (duplicate measurements on one visit by a nurse) and home (duplicate measurements on 7 days) blood pressure (BP) measurements and evaluation of electrocardiographic left ventricular hypertrophy (ECG-LVH, n = 1989/1540), carotid intima-media thickness (cIMT, n = 758/592), and pulse wave velocity (PWV, n = 237/158). ECG-LVH was diagnosed using Cornell voltage criteria. PWV was measured using whole-body impedance cardiography. Masked hypertension was defined as office BP less than 140/90mmHg with home BP at least 135/85mmHg and white-coat hypertension as office BP at least 140/90mmHg and home BP less than 135/85mmHg.Results: Masked and sustained hypertensive individuals had significantly higher age-adjusted and sex-adjusted Cornell voltage, cIMT, and PWV than normotensive individuals. White-coat hypertensive patients had higher age-adjusted and sex-adjusted Cornell voltage than normotensive individuals but significantly lower Cornell voltage and PWV than sustained hypertensive patients. The differences in Cornell voltage and PWV remained significant after adjustment for confounding factors. However, all differences became nonsignificant after adjustment for systolic home BP.Conclusion: Masked and sustained hypertension is accompanied by increased risk for hypertensive target organ damage, whereas white-coat hypertension seems to be a more benign phenomenon.
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