The Experts below are selected from a list of 3087 Experts worldwide ranked by ideXlab platform

Daichi Shimbo - One of the best experts on this subject based on the ideXlab platform.

Giuseppe Mancia - One of the best experts on this subject based on the ideXlab platform.

  • left ventricular hypertrophy in isolated and dual Masked Hypertension
    Journal of Clinical Hypertension, 2020
    Co-Authors: Cesare Cuspidi, Guido Grassi, Raffaella Delloro, Marijana Tadic, Rita Facchetti, Fosca Quartitrevano, Giuseppe Mancia
    Abstract:

    Masked Hypertension (MH) is defined as normal office blood pressure (BP) and elevated ambulatory BP (ABP) or home BP or both. This study assessed the association of MH (ie, isolated home, isolated ABP and dual MH) with echocardiographic left ventricular hypertrophy (LVH). The present analysis of the PAMELA study included 1087 untreated and treated participants with normal office BP and a measurable LV mass (LVM). A total of 193 individuals (17.7%) had any MH (ie, normal office BP, elevated ABP or home BP or both), 48 had dual MH (25%), 62 isolated ambulatory MH (32%), and 83 isolated home MH (43%). Average LVM indexed to body surface area was superimposable in the three MH phenotypes (being the largest difference between groups <3 g/m2 ) and significantly higher than in true normotensives. This was also for the LVH prevalence that varied across the MH subgroups in a narrow range (from 8.3% to 10.8%). In conclusion, individuals from the general population with isolated MH, in which either home or ABP was elevated, exhibited an increased risk of LVH similar to that entailed by dual MH. Our findings add the notion both home and ABP measurements are useful to more accurately assess the risk of LVH associated with MH in the community.

  • incident left ventricular hypertrophy in Masked Hypertension
    Hypertension, 2019
    Co-Authors: Cesare Cuspidi, Guido Grassi, Carla Sala, Marijana Tadic, Rita Facchetti, Fosca Quartitrevano, Giuseppe Mancia
    Abstract:

    In the PAMELA study (Pressioni Arteriose Monitorate e Loro Associazioni), clinical variables, an echocardiogram, as well as office and ambulatory blood pressure (ABP) were simultaneously measured a...

  • risk of new onset metabolic syndrome associated with white coat and Masked Hypertension data from a general population
    Journal of Hypertension, 2018
    Co-Authors: Cesare Cuspidi, Guido Grassi, Michele Bombelli, Marijana Tadic, Rita Facchetti, Carlac Sala, Giuseppe Mancia
    Abstract:

    Aim In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting new-onset metabolic syndrome (MetS). Methods The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat Hypertension (WCH), Masked Hypertension and sustained Hypertension. Results Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR = 1.75, CI 1.01-3.04, P = 0.0046), Masked Hypertension (OR = 2.58, CI 1.26-5.30; P = 0.009) and sustained Hypertension (OR = 2.14, CI 1.20-3.79, P = 0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-of-office BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P = 0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion Our study provides evidence that either isolated or combined BP elevations identified by office/ambulatory measurements, carry an increased risk of new-onset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

  • untreated Masked Hypertension and subclinical cardiac damage a systematic review and meta analysis
    American Journal of Hypertension, 2015
    Co-Authors: Cesare Cuspidi, Guido Grassi, Carla Sala, Marijana Tadic, Marta Rescaldani, Giuseppe Mancia
    Abstract:

    AIM: Data on the association of Masked Hypertension (MH) (i.e., normal office and elevated out-of-office blood pressure (BP)) with cardiac damage are scanty. We performed a meta-analysis in order to provide a comprehensive information on subclinical cardiac alterations in subjects with MH. DESIGN: Studies were identified by the following search terms: "Masked Hypertension," "white coat normotension," "isolated ambulatory Hypertension," "left ventricular mass," "left ventricular hypertrophy," "cardiac damage," and "echocardiography." Full articles published in English language providing data on left ventricular (LV) mass and/or prevalence of LV hypertrophy in MH, as assessed by ambulatory BP monitoring, were considered. RESULTS: Overall, 4,884 untreated subjects (2,467 normotensive, 776 MH, and 1,641 sustained hypertensive individuals) of both genders included in 12 studies were analyzed. LV mass index showed a progressive increase from normotensive (79.2 ± 0.35 g/m(2)) to MH (91.6 ± 4.0 g/m(2)) (standard difference in means (SDM): 0.50 ± 0.11, confidence interval (CI): 0.28-0.73, P < 0.01) and to hypertensive subjects (102.9 ± 3.3g/m(2)) (SDM: 0.22 ± 0.07, CI: 0.09-0.35, P < 0.01). After assessing data for publication bias, the difference between groups was still significant. CONCLUSIONS: Our findings support an association between MH and increased risk of LV structural alterations compared to true normotensive individuals. Due to the worse cardiovascular prognosis associated with subclinical cardiac damage, subjects with MH should be carefully screened in order to detect hypertensive organ damage and provide appropriate therapeutic interventions.

  • untreated Masked Hypertension and carotid atherosclerosis a meta analysis
    Blood Pressure, 2015
    Co-Authors: Cesare Cuspidi, Guido Grassi, Carla Sala, Marijana Tadic, Marta Rescaldani, Giuseppe Antonio De Giorgi, Giuseppe Mancia
    Abstract:

    AbstractAim. Masked Hypertension (MH) is recognized as a clinical entity with an unfavorable cardiovascular prognosis; a limited number of reports, however, investigated the impact of this condition on subclinical vascular damage. We performed a meta-analysis aimed at evaluating the association of MH with subclinical carotid atherosclerosis in initially untreated subjects. Design. Studies were identified by the following search terms: “Masked Hypertension”, “isolated clinic normotension”, “white coat normotension”, “carotid artery”, “carotid atherosclerosis”, “carotid intima-media thickness”, “carotid damage” and “carotid thickening”. Full articles published in English language reporting data from studies performed in untreated adult individuals were considered. Results. Overall, 2752 untreated subjects (1039 normotensive, 497 MH and 766 hypertensive individuals) of both genders were included in five studies (sample size range 18–222 for MH participants). Common carotid intima-media thickness (IMT) showed...

Paul Muntner - One of the best experts on this subject based on the ideXlab platform.

  • short term reproducibility of Masked Hypertension among adults without office Hypertension
    Hypertension, 2020
    Co-Authors: Laura P Cohen, Paul Muntner, Joseph E Schwartz, Daichi Shimbo, Edmund D Anstey, Daniel N Pugliese, Jessica P Christian, Stephanie Jou, Natalie A Bello
    Abstract:

    The 2017 American College of Cardiology/American Heart Association blood pressure (BP) Hypertension Clinical Practice Guidelines recommends ambulatory BP monitoring to detect Masked Hypertension. D...

  • diagnosing Masked Hypertension using ambulatory blood pressure monitoring home blood pressure monitoring or both
    Hypertension, 2018
    Co-Authors: Edmund D Anstey, Paul Muntner, Natalie A Bello, Joseph E Schwartz, Ian M Kronish, Yuichiro Yano, Daniel N Pugliese, Kristi Reynolds, Daichi Shimbo
    Abstract:

    Guidelines recommend measuring out-of-clinic blood pressure (BP) to identify Masked Hypertension (MHT) defined by out-of-clinic BP in the hypertensive range among individuals with clinic-measured BP not in the hypertensive range. The aim of this study was to determine the overlap between ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) for the detection of MHT. We analyzed data from 333 community-dwelling adults not taking antihypertensive medication with clinic BP <140/90 mm Hg in the IDH study (Improving the Detection of Hypertension). Any MHT was defined by the presence of daytime MHT (mean daytime BP ≥135/85 mm Hg), 24-hour MHT (mean 24-hour BP ≥130/80 mm Hg), or nighttime MHT (mean nighttime BP ≥120/70 mm Hg). Home MHT was defined as mean BP ≥135/85 mm Hg on HBPM. The prevalence of MHT was 25.8% for any MHT and 11.1% for home MHT. Among participants with MHT on either ABPM or HBPM, 29.5% had MHT on both ABPM and HBPM; 61.1% had MHT only on ABPM; and 9.4% of participants had MHT only on HBPM. After multivariable adjustment and compared with participants without MHT on ABPM and HBPM, those with MHT on both ABPM and HBPM and only on ABPM had a higher left ventricular mass index (mean difference [SE], 12.7 [2.9] g/m2, P<0.001; and 4.9 [2.1] g/m2, P=0.022, respectively), whereas participants with MHT only on HBPM did not have an increased left ventricular mass index (mean difference [SE], -1.9 [4.8] g/m2, P=0.693). These data suggest that conducting ABPM will detect many individuals with MHT who have an increased cardiovascular disease risk.

  • Masked Hypertension and kidney function decline the jackson heart study
    Journal of Hypertension, 2018
    Co-Authors: Stanford Mwasongwe, John N Booth, Adolfo Correa, Yuani Min, Ronit Katz, Mario Sims, Bessie A Young, Paul Muntner
    Abstract:

    Background Hypertension diagnosed by blood pressure (BP) measured in the clinic is associated with rapid kidney function decline (RKFD) and incident chronic kidney disease (CKD). The extent to which Hypertension defined using out-of-clinic BP measurements is associated with these outcomes is unclear. Methods We evaluated the association of any Masked Hypertension (daytime SBP/DBP ≥ 135/85 mmHg, night-time SBP/DBP ≥ 120/70 mmHg or 24-h SBP/DBP ≥ 130/80 mmHg) with RKFD and incident CKD among 676 African-Americans in the Jackson Heart Study with clinic-measured SBP/DBP less than 140/90 mmHg who completed ambulatory BP monitoring in 2000-2004. RKFD was defined as a decline in estimated glomerular filtration rate (eGFR) at least 30% and incident CKD was defined as development of eGFR less than 60 ml/min per 1.73 m with an at least 25% decline in eGFR between 2000-2004 and 2009-2013. Results The mean age of participants was 57.6 years, 28.8% were men and 52.7% had any Masked Hypertension. After a median follow-up of 8 years, 13.8 and 8.6% of participants had RKFD and incident CKD, respectively. In unadjusted analyses, Masked Hypertension was associated with an increased odds for incident CKD [odds ratio (OR) 2.20, 95% confidence interval (CI) 1.22, 3.97]. This association remained statistically significant after adjustment for demographic characteristics, baseline eGFR and albumin-to-creatinine ratio (OR 1.95, 95% CI 1.04, 3.67) but was eliminated after propensity score adjustment (OR 1.62, 95% CI 0.87, 3.00). There was no association between Masked Hypertension and RKFD. Conclusion Masked Hypertension may be associated with the development of CKD in African-Americans.

  • predicted atherosclerotic cardiovascular disease risk and Masked Hypertension among blacks in the jackson heart study
    Circulation-cardiovascular Quality and Outcomes, 2017
    Co-Authors: Edmund D Anstey, John N Booth, Paul Muntner, Yuani Min, Marwah Abdalla, Tanya M Spruill, Daichi Shimbo
    Abstract:

    Background— Among individuals without Hypertension based on clinic blood pressure (BP), it is unclear who should be screened for Masked Hypertension, defined as having Hypertension based on out-of-clinic BP. We hypothesized that individuals with a higher 10-year predicted atherosclerotic cardiovascular disease (ASCVD) risk, calculated using the pooled cohort risk equations, have a higher prevalence of Masked Hypertension. Methods and Results— We analyzed data from the Jackson Heart Study—a population-based cohort of blacks—to determine the association of predicted ASCVD risk with Masked Hypertension. The sample included 644 participants, 40 to 79 years of age, with clinic systolic/diastolic BP Conclusions— Higher ASCVD risk was associated with an increased prevalence of Masked Hypertension. Although the discrimination of ASCVD risk for Masked Hypertension was not superior to clinic BP, risk prediction equations may be useful for identifying the subgroup of individuals with both Masked Hypertension and high predicted ASCVD risk.

  • metabolic syndrome and Masked Hypertension among african americans the jackson heart study
    Journal of Clinical Hypertension, 2017
    Co-Authors: Lisandro D Colantonio, Daichi Shimbo, Gbenga Ogedegbe, April P Carson, Mario Sims, Edmund D Anstey, Marwah Abdalla, Paul Muntner
    Abstract:

    The metabolic syndrome is associated with higher ambulatory blood pressure. The authors studied the association of metabolic syndrome and Masked Hypertension (MHT) among African Americans with clinic-measured systolic/diastolic blood pressure (SBP/DBP) <140/90 mm Hg in the Jackson Heart Study. MHT was defined as daytime, nighttime, or 24-hour Hypertension on ambulatory blood pressure monitoring. Among 359 participants not taking antihypertensive medication, the metabolic syndrome was associated with MHT (prevalence ratio, 1.38; 95% confidence interval, 1.10-1.74]). When metabolic syndrome components (clinic SBP/DBP 130-139/85-89 mm Hg, abdominal obesity, impaired glucose, low high-density lipoprotein cholesterol, high triglycerides) were analyzed separately, only clinic SBP/DBP 130-139/85-89 mm Hg was associated with MHT (prevalence ratio, 1.90; 95% confidence interval, 1.56-2.32]). The metabolic syndrome was not associated with MHT among participants not taking antihypertensive medication with SBP/DBP 130-139/85-89 and <130/85 mm Hg, separately, or among participants taking antihypertensive medication (n=393). Ambulatory blood pressure monitoring screening for MHT among African Americans should be considered based on clinic BP, not metabolic syndrome.

Guido Grassi - One of the best experts on this subject based on the ideXlab platform.

  • left ventricular hypertrophy in isolated and dual Masked Hypertension
    Journal of Clinical Hypertension, 2020
    Co-Authors: Cesare Cuspidi, Guido Grassi, Raffaella Delloro, Marijana Tadic, Rita Facchetti, Fosca Quartitrevano, Giuseppe Mancia
    Abstract:

    Masked Hypertension (MH) is defined as normal office blood pressure (BP) and elevated ambulatory BP (ABP) or home BP or both. This study assessed the association of MH (ie, isolated home, isolated ABP and dual MH) with echocardiographic left ventricular hypertrophy (LVH). The present analysis of the PAMELA study included 1087 untreated and treated participants with normal office BP and a measurable LV mass (LVM). A total of 193 individuals (17.7%) had any MH (ie, normal office BP, elevated ABP or home BP or both), 48 had dual MH (25%), 62 isolated ambulatory MH (32%), and 83 isolated home MH (43%). Average LVM indexed to body surface area was superimposable in the three MH phenotypes (being the largest difference between groups <3 g/m2 ) and significantly higher than in true normotensives. This was also for the LVH prevalence that varied across the MH subgroups in a narrow range (from 8.3% to 10.8%). In conclusion, individuals from the general population with isolated MH, in which either home or ABP was elevated, exhibited an increased risk of LVH similar to that entailed by dual MH. Our findings add the notion both home and ABP measurements are useful to more accurately assess the risk of LVH associated with MH in the community.

  • incident left ventricular hypertrophy in Masked Hypertension
    Hypertension, 2019
    Co-Authors: Cesare Cuspidi, Guido Grassi, Carla Sala, Marijana Tadic, Rita Facchetti, Fosca Quartitrevano, Giuseppe Mancia
    Abstract:

    In the PAMELA study (Pressioni Arteriose Monitorate e Loro Associazioni), clinical variables, an echocardiogram, as well as office and ambulatory blood pressure (ABP) were simultaneously measured a...

  • when office blood pressure is not enough the case of Masked Hypertension
    American Journal of Hypertension, 2019
    Co-Authors: Cesare Cuspidi, Carla Sala, Marijana Tadic, Guido Grassi
    Abstract:

    An increasing attention has been devoted in the last two decades to Masked Hypertension (MH), a condition characterized by the fact that classification of a normal blood pressure (BP) status by office measurements is not confirmed by home and/or ambulatory BP monitoring (ABPM). MH definition (i.e., normal office BP, but high out-of-office BP) should be restricted to untreated subjects (true MH) whereas Masked uncontrolled Hypertension (MUCH) reserved to treated patients previously classified as hypertensives, presenting normal office BP and high ABPM or home values. Both MH and MUCH are associated with metabolic alterations, comorbidities, and Hypertension-mediated organ damage (HMOD). Furthermore, the risk of cardiovascular events related to these conditions has been shown to be close or greater than that of sustained Hypertension. This review discusses available evidence about MH and MUCH by focusing on its prevalence, clinical correlates, association with HMOD, prognostic significance, and their therapeutic implications.

  • risk of new onset metabolic syndrome associated with white coat and Masked Hypertension data from a general population
    Journal of Hypertension, 2018
    Co-Authors: Cesare Cuspidi, Guido Grassi, Michele Bombelli, Marijana Tadic, Rita Facchetti, Carlac Sala, Giuseppe Mancia
    Abstract:

    Aim In the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, clinical and metabolic variables as well as office, home and ambulatory blood pressure (BP) values were simultaneously measured at baseline and after a 10-year follow-up. The study design allowed us to assess the value of selective and combined elevation of different BP phenotypes in predicting new-onset metabolic syndrome (MetS). Methods The present analysis included 1182 participants without MetS at baseline, as defined by the APT III criteria. On the basis of office, 24-h ambulatory BP and home values, participants were divided into four groups: normal, white-coat Hypertension (WCH), Masked Hypertension and sustained Hypertension. Results Compared with participants with in-office and out-of-office normal BP, a greater incidence of new-onset age-adjusted and sex-adjusted MetS was observed in WCH (OR = 1.75, CI 1.01-3.04, P = 0.0046), Masked Hypertension (OR = 2.58, CI 1.26-5.30; P = 0.009) and sustained Hypertension (OR = 2.14, CI 1.20-3.79, P = 0.009)) when out-of-office BP was defined by ambulatory criteria. This was not the case when out-of-office BP was defined by home criteria, as only the WCH group showed a greater risk (OR 2.16, CI 1.28-3.63, P = 0.003). Similar findings were obtained for single components of the MetS such as abdominal obesity and hyperglycemia. Conclusion Our study provides evidence that either isolated or combined BP elevations identified by office/ambulatory measurements, carry an increased risk of new-onset MetS, whereas, only WCH is associated with a greater risk of incident MetS whenever BP phenotypes are identified by office/home measurements. In a clinical perspective, a comprehensive evaluation of BP status based on office/ambulatory measurements may improve diagnosis of new-onset MetS and activate measures for its prevention.

  • untreated Masked Hypertension and subclinical cardiac damage a systematic review and meta analysis
    American Journal of Hypertension, 2015
    Co-Authors: Cesare Cuspidi, Guido Grassi, Carla Sala, Marijana Tadic, Marta Rescaldani, Giuseppe Mancia
    Abstract:

    AIM: Data on the association of Masked Hypertension (MH) (i.e., normal office and elevated out-of-office blood pressure (BP)) with cardiac damage are scanty. We performed a meta-analysis in order to provide a comprehensive information on subclinical cardiac alterations in subjects with MH. DESIGN: Studies were identified by the following search terms: "Masked Hypertension," "white coat normotension," "isolated ambulatory Hypertension," "left ventricular mass," "left ventricular hypertrophy," "cardiac damage," and "echocardiography." Full articles published in English language providing data on left ventricular (LV) mass and/or prevalence of LV hypertrophy in MH, as assessed by ambulatory BP monitoring, were considered. RESULTS: Overall, 4,884 untreated subjects (2,467 normotensive, 776 MH, and 1,641 sustained hypertensive individuals) of both genders included in 12 studies were analyzed. LV mass index showed a progressive increase from normotensive (79.2 ± 0.35 g/m(2)) to MH (91.6 ± 4.0 g/m(2)) (standard difference in means (SDM): 0.50 ± 0.11, confidence interval (CI): 0.28-0.73, P < 0.01) and to hypertensive subjects (102.9 ± 3.3g/m(2)) (SDM: 0.22 ± 0.07, CI: 0.09-0.35, P < 0.01). After assessing data for publication bias, the difference between groups was still significant. CONCLUSIONS: Our findings support an association between MH and increased risk of LV structural alterations compared to true normotensive individuals. Due to the worse cardiovascular prognosis associated with subclinical cardiac damage, subjects with MH should be carefully screened in order to detect hypertensive organ damage and provide appropriate therapeutic interventions.

Joseph E Schwartz - One of the best experts on this subject based on the ideXlab platform.

  • short term reproducibility of Masked Hypertension among adults without office Hypertension
    Hypertension, 2020
    Co-Authors: Laura P Cohen, Paul Muntner, Joseph E Schwartz, Daichi Shimbo, Edmund D Anstey, Daniel N Pugliese, Jessica P Christian, Stephanie Jou, Natalie A Bello
    Abstract:

    The 2017 American College of Cardiology/American Heart Association blood pressure (BP) Hypertension Clinical Practice Guidelines recommends ambulatory BP monitoring to detect Masked Hypertension. D...

  • sex differences in Masked Hypertension the coronary artery risk development in young adults study
    Journal of Hypertension, 2019
    Co-Authors: Daniel N Pugliese, John N Booth, Natalie A Bello, Edmund D Anstey, Luqin Deng, Byron C Jaeger, James M Shikany, Donald M Lloydjones, Cora E Lewis, Joseph E Schwartz
    Abstract:

    Objective:To evaluate the association of sex with Masked Hypertension, defined by out-of-clinic Hypertension based on ambulatory blood pressure monitoring (ABPM) among adults without Hypertension based on blood pressure (BP) measured in the clinic, after adjusting for potential confounders.Methods:W

  • diagnosing Masked Hypertension using ambulatory blood pressure monitoring home blood pressure monitoring or both
    Hypertension, 2018
    Co-Authors: Edmund D Anstey, Paul Muntner, Natalie A Bello, Joseph E Schwartz, Ian M Kronish, Yuichiro Yano, Daniel N Pugliese, Kristi Reynolds, Daichi Shimbo
    Abstract:

    Guidelines recommend measuring out-of-clinic blood pressure (BP) to identify Masked Hypertension (MHT) defined by out-of-clinic BP in the hypertensive range among individuals with clinic-measured BP not in the hypertensive range. The aim of this study was to determine the overlap between ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) for the detection of MHT. We analyzed data from 333 community-dwelling adults not taking antihypertensive medication with clinic BP <140/90 mm Hg in the IDH study (Improving the Detection of Hypertension). Any MHT was defined by the presence of daytime MHT (mean daytime BP ≥135/85 mm Hg), 24-hour MHT (mean 24-hour BP ≥130/80 mm Hg), or nighttime MHT (mean nighttime BP ≥120/70 mm Hg). Home MHT was defined as mean BP ≥135/85 mm Hg on HBPM. The prevalence of MHT was 25.8% for any MHT and 11.1% for home MHT. Among participants with MHT on either ABPM or HBPM, 29.5% had MHT on both ABPM and HBPM; 61.1% had MHT only on ABPM; and 9.4% of participants had MHT only on HBPM. After multivariable adjustment and compared with participants without MHT on ABPM and HBPM, those with MHT on both ABPM and HBPM and only on ABPM had a higher left ventricular mass index (mean difference [SE], 12.7 [2.9] g/m2, P<0.001; and 4.9 [2.1] g/m2, P=0.022, respectively), whereas participants with MHT only on HBPM did not have an increased left ventricular mass index (mean difference [SE], -1.9 [4.8] g/m2, P=0.693). These data suggest that conducting ABPM will detect many individuals with MHT who have an increased cardiovascular disease risk.

  • abstract 120 long term stability of the Masked Hypertension phenotype and responsiveness of Masked Hypertension to antihypertensive treatment findings from the Masked Hypertension study
    Hypertension, 2018
    Co-Authors: Ian M Kronish, Daichi Shimbo, Justin Young, Joseph E Schwartz
    Abstract:

    Background: Prior studies have assessed the short-term reproducibility of the Masked Hypertension (MHT) phenotype. Less is known about the stability of MHT over time or its responsiveness to BP med...

  • prevalence of Masked Hypertension among us adults with nonelevated clinic blood pressure
    American Journal of Epidemiology, 2017
    Co-Authors: Claire Y Wang, Paul Muntner, Daichi Shimbo, Andrew E Moran, Lawrence R Krakoff, Joseph E Schwartz
    Abstract:

    Masked Hypertension (MHT), defined as nonelevated blood pressure (BP) in the clinic setting and elevated BP assessed by ambulatory monitoring, is associated with increased risk of target organ damage, cardiovascular disease, and mortality. Currently, no estimate of MHT prevalence exists for the general US population. After pooling data from the Masked Hypertension Study (n = 811), a cross-sectional clinical investigation of systematic differences between clinic BP and ambulatory BP (ABP) in a community sample of employed adults in the New York City metropolitan area (2005-2012), and the National Health and Nutrition Examination Survey (NHANES; 2005-2010; n = 9,316), an ongoing nationally representative US survey, we used multiple imputation to impute ABP-defined Hypertension status for NHANES participants and estimate MHT prevalence among the 139 million US adults with nonelevated clinic BP, no history of overt cardiovascular disease, and no use of antihypertensive medication. The estimated US prevalence of MHT in 2005-2010 was 12.3% of the adult population (95% confidence interval: 10.0, 14.5)-approximately 17.1 million persons aged ≥21 years. Consistent with prior research, estimated MHT prevalence was higher among older persons, males, and those with preHypertension or diabetes. To our knowledge, this study provides the first estimate of US MHT prevalence-nearly 1 in 8 adults with nonelevated clinic BP-and suggests that millions of US adults may be misclassified as not having Hypertension.