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    What About Masked Hypertension?

    Is it white coat hypertension in disguise?

    In my previous review of white coat hypertension (WCH), I stressed that ambulatory blood pressure monitoring (ABPM) has found a place in the management of hypertension.1 Blood pressures obtained with ABPM are superior to office readings for the prediction of hypertensive end-organ damage.2 In fact, the diagnosis of WCH requires ABPM.2

    This discussion leads us to another diagnosis that necessitates ambulatory monitoring—masked hypertension. This condition may be defined as normal blood pressure readings in the physician’s office and elevated readings outside the office as measured by ABPM.2 Test your current knowledge of masked hypertension with this brief 2-question quiz:

    1. Which of the following statements is/are true?

    A. Masked hypertension is more common in persons with stressful occupations, obstructive sleep apnea, and chronic kidney disease.

    B. Masked hypertension is not more common in persons with diabetes.

    C. In persons described as normotensive, masked hypertension is associated with increased cardiovascular risk—in fact, twice the risk.

    D. It appears that masked hypertension is often the consequence of nocturnal blood pressure elevations.

    Answer, discussion, and next question>>

    Gregory W. Rutecki, MD
    Dr Rutecki is with the Cleveland Clinic National Consultation Service.


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