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The Complexity of Masked Hypertension: Diagnostic and Management Challenges

  • Blood Pressure Monitoring and Management (G Ogedegbe and JA Staessen, Section Editors)
  • Published:
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Abstract

Masked hypertension, defined as discordant in-office normotension versus out-of-office hypertension, is present in approximately 10 % to 40 % of patients not receiving antihypertensive treatment. Not only are persons with prehypertension more likely to have masked hypertension, but they also frequently develop target organ damage before transitioning to established sustained hypertension. Moreover, the percentage of persons with masked hypertension increases in the presence of cardiovascular disease, diabetes, or chronic renal failure. The gold standard for diagnosing masked hypertension is the 24-hour ambulatory BP monitor (ABPM), but home BP monitoring (HBPM) has also been a useful alternative procedure. Importantly, initiating antihypertensive treatment exclusively with the use of in-office BP monitoring may result in almost one-third of patients remaining with high-risk masked uncontrolled hypertension, which underscores the importance of HBPM and ABPM as supplements to in-office BP monitoring for the effective treatment of hypertension.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgment

A special thank you to Dr. Kei Asayama for taking the time to review this manuscript.

Compliance with Ethics Guidelines

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Conflict of Interest

Stanley S. Franklin and Nathan D. Wong declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA

    Stanley S. Franklin & Nathan D. Wong

  2. Heart Disease Prevention Program, C240 Medical Sciences (Offices C340A-B), University of California, Irvine, CA, 92697-4079, USA

    Stanley S. Franklin

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  1. Stanley S. Franklin
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  2. Nathan D. Wong
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Correspondence to Stanley S. Franklin.

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This article is part of the Topical Collection on Blood Pressure Monitoring and Management

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Franklin, S.S., Wong, N.D. The Complexity of Masked Hypertension: Diagnostic and Management Challenges. Curr Hypertens Rep 16, 474 (2014). https://doi.org/10.1007/s11906-014-0474-4

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  • DOI: https://doi.org/10.1007/s11906-014-0474-4

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