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Ann Geriatr Med Res  <  Volume 14(2); 2010 <  Articles

J Korean Geriatr Soc 2010; 14(2): 70-76  https://doi.org/10.4235/jkgs.2010.14.2.70
Characteristics and Predictors of Masked Hypertension in Elderly Patients with Well-controlled Hypertension
Sung-Ji Park, MD1, Jeong Bae Park, MD2, Dong-Ju Choi, MD3, Ho Joong Youn, MD4,
Chang Gyu Park, MD5, Young Keun Ahn, MD6, Joon-Han Shin, MD7, Dong Woon Kim, MD8,
Se Joong Rim, MD9
1Sungkyunkwan University Samsung Medical Center, 2Kwandong University Cheil Hospital, 3Seoul National University Bundang Hospital, 4Catholic University Seoul Hospital, 5Korea University Guro Hospital, 6Chonnam National University Hospital, 7Ajou University Hospital, 8Chungbuk National University Hospital, 9Yonsei University Hospital, Korea
Received: February 19, 2010; Accepted: March 30, 2010; Published online: January 1, 2010.
© The Korean Geriatrics Society. All rights reserved.

Abstract
Background: Clinic-based blood pressure measurements may lead to untoward results in the management of hypertension. Masked hypertension (MH) has been shown to be related to a poor prognosis due to its hidden nature. The purpose of this study is to present the clinical predictors of MH in elderly patients over 65 years with well-controlled clinic blood pressure (CBP) and to evaluate the gap, the ‘mask effect’ (negative white-coat effect), between CBP and home blood pressure (HBP).
Methods: The BPs of 1,019 treated hypertensive patients were measured by a doctor at an out-patient clinic and by patients themselves at home. Clinical parameters for MH were analyzed in 511 patients with well-controlled CBP (45.6% men, mean age 57.1±9.0 years).
Results: Among the patients over 65 years (n=113, 46.8% men, mean age 68.4±7.3 years) and with well-controlled CBP, the prevalence of MH was 26.5% (30 patients). In multivariate-adjusted analysis, the risk of MH increased with physical inactivity (odds ratio [OR], 2.942; 95% confidence interval [CI], 1.039-8.329; p=0.042), use of beta-blocker (OR, 4.242; 95% CI, 1.528-11.785; p=0.06) and systolic clinic BP (OR, 1.083; 95% CI, 0.017-1.154; p=0.013). Furthermore, HBP correlated well with CBP (r=0.329; p<0.001) and further with degree of ME (r=0.723; p<0.001).
Conclusion: In looking for MH, it would be useful to carefully assess patients taking beta-blockers, having higher CBP, and who are physically inactive by using self-monitoring home or ambulatory BP monitoring.
Keywords: Masked hypertension, Home blood pressure, Elderly hypertension


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