Unmasking masked hypertension: prevalence, clinical implications, diagnosis, correlates and future directions.
Unmasking masked hypertension: prevalence, clinical implications, diagnosis, correlates and future directions.
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DOI：
10.1038/jhh.2014.9
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发表时间：
2014-09
影响因子：
2.7
通讯作者：
中科院分区：
文献类型：
--
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“隐匿性高血压”定义为门诊血压（BP）未升高，门诊外平均BP升高，通常通过动态BP监测确定。大约15-30%的非临床血压升高的成年人患有隐性高血压。与持续正常血压（门诊和动态血压未升高）相比，隐匿性高血压与心血管发病率和死亡率风险增加相关，这与持续高血压（门诊和动态血压升高）相关风险相似或接近。增加的心血管风险和无法通过临床血压测量的常规方法诊断的汇合使得隐匿性高血压成为一个重要的公共卫生问题。然而，许多重要的问题仍然存在。首先，不同研究对隐匿性高血压的定义不同。此外，在临床环境中排除隐匿性高血压的最佳方法也仍然未知。目前尚不清楚在识别隐性高血压时，家庭血压监测是否足以替代动态血压监测。很少有研究探讨可能解释隐匿性高血压的机制途径。最后，关于治疗隐性高血压患者的最佳方法的数据很少。在此，我们回顾了目前有关隐性高血压的文献，包括定义，患病率，临床意义，特殊患者人群，相关因素，与诊断，治疗相关的问题，以及未来的研究领域。
‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared to sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment, and areas for future research.
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影响因子：
4.9
作者：
Myers, Martin G.;Godwin, Marshall;Kaczorowski, Janusz
通讯作者：
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作者：
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Pepin, Jean-Louis
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通讯作者：
Kiss, Alexander
影响因子：
4.9
作者：
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通讯作者：
Bursztyn, Michael
影响因子：
8.3
作者：
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通讯作者：
Sega, R