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masked hypertension

- normal office blood pressure; high ambulatory blood pressure - normal office blood pressure; left ventricular hypertrophy [1] * opposite of white-coat hypertension - note BP goals for ambulatory blood pressure may differ from those of office blood pressure [1]* - masked hypertension seems to have worse prognosis than sustained hypertension (both ambulatory & clinic-based hypertension) [3] Special laboratory: - electrocardiogram may reveal left ventricular hypertrophy (LVH)* - echocardiogram may confirm LVH Management: - initiate antihypertensive treatment if daytime ambulatory BP or home BP is elevated after 3 month trial of diet & lifestyle - ACP/ACC/AHA BP goal < 130/80 mm Hg

Related

white-coat hypertension

General

hypertension (HTN, high blood pressure, HBP)

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 15, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2015, 2018, 2021.
  2. Stergiou GS, Asayama K, Thijs L et al Prognosis of white-coat and masked hypertension: International Database of Home blood pressure in relation to Cardiovascular Outcome. Hypertension. 2014 Apr;63(4):675-82. PMID: 24420553 Free Article
  3. Banegas JR, Ruilope LM, de la Sierra A et al Relationship between Clinic and Ambulatory Blood-Pressure Measurements and Mortality. N Engl J Med 2018; 378:1509-1520. April 19. 2018 PMID: 29669232 http://www.nejm.org/doi/full/10.1056/NEJMoa1712231