Analysis of Systolic Blood Pressure Level and Short-Term Variability in Masked Hypertension

Abstract

Background: Patients with masked hypertension are at an elevated risk of cardiovascular events and all-cause death. This risk is close to that of sustained hypertension. The mean value and short-term variability of systolic blood pressure are considered to be risk factors for organ damage in hypertension.

Objective: To investigate the mean value and short-term variability of systolic blood pressure in patients with masked hypertension.

Methods: According to the results of in-clinic and ambulatory blood pressure measurement, participants were divided into four groups: normotension group, controlled hypertension group, masked hypertension group, and sustained hypertension group. The mean value and short-term variability of systolic blood pressure of masked hypertension group were evaluated by comparison with the other three groups.

Results: A total of 250 subjects were enrolled, with an average age of 65.46 ± 8.76 years, and 166 (66.4%) were male, including 62 in the normotension group, 78 in the controlled hypertension group, 69 in the masked hypertension group, and 41 in the sustained hypertension group. Compared with the normotension group and controlled hypertension group, the mean value, blood pressure load, standard deviation, and coefficient of variation of systolic blood pressure over 24 hours and during the day and night, were all higher in the masked hypertension group (P < 0.05), while the rate of the nocturnal systolic blood pressure decline was lower (P < 0.05). There were no statistically significant differences in the above indexes between the masked hypertension group and sustained hypertension group (P > 0.05).

Conclusion: There are higher mean value of systolic blood pressure and greater short-term variability in masked hypertension patients. Identification of masked hypertension is an important challenge in the clinic.

Figure 1

A flow chart of the current study.

Figure 2

Comparison of systolic blood pressure parameters of ambulatory blood pressure monitoring in the four groups. (a) 24 h systolic blood pressure, (b) daytime systolic blood pressure, (c) nighttime systolic blood pressure, (d) 24 h systolic blood pressure load, (e) daytime systolic blood pressure load, (f) nighttime systolic blood pressure load, (g) 24 h systolic blood pressure standard deviation, (h) daytime systolic blood pressure standard deviation, (i) nighttime systolic blood pressure standard deviation, (j) 24 h systolic blood pressure coefficient of variation, (k) daytime systolic blood pressure coefficient of variation, (l) nighttime systolic blood pressure coefficient of variation, and (m) nocturnal systolic blood pressure decline rate.