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Masked Hypertension in CKD: Increased Prevalence and Risk for Cardiovascular and Renal Events

  • Megha Babu
  • Paul DrawzEmail author
Hypertension (DS Geller and DL Cohen, Section Editors)
  • 218 Downloads
Part of the following topical collections:
  1. Topical Collection on Hypertension

Abstract

Purpose of Review

Hypertension and chronic kidney disease (CKD) are inextricably linked. The causal nature of the relationship is bidirectional. This relationship holds when blood pressure is assessed in the clinic and outside the clinic with home and ambulatory blood pressure monitoring. Patients with CKD are more likely to have high-risk hypertension phenotypes, such as masked and sustained hypertension, and are at increased risk for cardiovascular disease. The purpose of this review is to describe the increased prevalence of masked hypertension in patients with CKD and then describe the increased risk for target organ damage and adverse clinical events associated with masked hypertension in patients with CKD.

Recent Findings

The prevalence of masked hypertension is greater in patients with CKD than that of the general population. Recent studies have demonstrated that masked hypertension is associated with increased risk for target organ damage including left ventricular hypertrophy, elevated pulse wave velocity, proteinuria, and decreased estimated glomerular filtration rate in patients with CKD. Additionally, in patients with CKD, masked hypertension is associated with increased risk for cardiovascular disease, end-stage renal disease, and all-cause mortality.

Summary

Patients with CKD are at increased risk for masked hypertension. Masked hypertension is associated with increased risk for target organ damage and adverse cardiovascular and renal outcomes in patients with CKD. Further research is necessary to better understand the pathophysiology of masked hypertension, the optimal method for diagnosing masked hypertension, and to determine whether masked hypertension is a modifiable risk factor.

Keywords

Hypertension Chronic kidney disease Cardiovascular disease Masked hypertension Ambulatory blood pressure monitoring 

Notes

Acknowledgments

The authors would like to acknowledge Craig Solid of Solid Research Group for his assistance with manuscript preparation.

Compliance with Ethical Standards

Conflict of Interest

Megha Babu and Paul Drawz 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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Essentia HealthFargoUSA
  2. 2.Division of Renal Diseases & HypertensionUniversity of MinnesotaMinneapolisUSA

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