High prevalence of masked hypertension confirmed among blacks

American Society of Hypertension 2011 Annual Scientific Meeting and Exposition

NEW YORK — New research presented here has confirmed previous data that indicated a high prevalence of masked hypertension among blacks and further reinforces the importance of ambulatory blood pressure monitoring to help identify patients with high BP who do not present as such at doctors’ office visits.

The preliminary study included 38 black patients (mean age, 51 years; 86.8% women) from the Philadelphia region who were sedentary, nondiabetic, nonsmoking, not on antihypertensive medication and did not have cardiovascular disease. Office BP measurements were taken during three visits on an average of three readings per visit, whereas ambulatory BP monitoring was performed on a typical day of the patient and was set to go off at 30-minute intervals during the day (6 a.m. to 10 p.m.) and 60-minute intervals during the night (10 p.m. to 6 a.m.).

According to study data, the BP measurements at the office were 124.4 mm Hg/79.1 mm Hg for the first visit, 126.4 mm Hg/80.1 mm Hg for the second visit 1 week later and 128.7 mm Hg/79.7 mm Hg for the third, whereas the mean ambulatory BP monitoring for 24 hours was 126.7 mm Hg/78.5 mm Hg (daytime, 128.4 mm Hg/80.2 mm Hg; nighttime, 116.8 mm Hg/68.6 mm Hg). The prevalence of masked hypertension decreased with each visit, from 59% on the first visit to 40% on the second visit and 38% on the third visit. Additionally, as an average for all three BP office measurements, roughly 45% of the population consistently had masked hypertension.

“The take-home message is office BP may not be sufficient, especially in this cohort,” study researcher Praveen Veerabhadrappa, MD, MS, research fellow, International Society of Hypertension Doctoral Candidate, Hypertension Molecular & Applied Physiology Lab, said in a press conference. “Close to 45% had masked hypertension, and they were not even aware they had hypertension. They may require some kind of intervention, whether it be nonpharmacological or pharmacological.” – by Brian Ellis

For more information:

Veerabhadrappa P. LB-PO-03. Presented at: American Society of Hypertension 2011 Annual Scientific Meeting and Exposition; May 21-24, 2011; New York.

Disclosure: Dr. Veerabhadrappa reports no relevant financial disclosures.

If you look at end-organ damage for African Americans compared with whites for the same level of office BP, African Americans have significantly higher rates of stroke, kidney disease and HF. This is probably the reason (for reasons that we don’t quite understand yet) that African Americans have higher BP outside the office than inside the office. The implication then is we can’t be complacent with a normal BP for an African American in the office. We are going to have to do more ambulatory BP monitoring and home monitoring.

– Robert A. Phillips, MD, PhD
Professor of Medicine,
University of Massachusetts Medical School, Worcester

Disclosure: Dr. Phillips reports no relevant financial disclosures.

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