| Characteristics and Predictors of Masked Hypertension in Elderly Patients with Well-controlled Hypertension |
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Sung Ji Park, Jeong Bae Park, Dong Ju Choi, Ho Joong Youn, Chang Gyu Park, Young Keun Ahn, Joon Han Shin, Dong Woon Kim, Se Joong Rim |
1Sungkyunkwan University Samsung Medical Center, Korea.
2Kwandong University Cheil Hospital, Korea.
3Seoul National University Bundang Hospital, Korea. djchoi@snu.ac.kr
4Catholic University Seoul Hospital, Korea.
5Korea University Guro Hospital, Korea.
6Chonnam National University Hospital, Korea.
7Ajou University Hospital, Korea.
8Chungbuk National University Hospital, Korea.
9Yonsei University Hospital, Korea. |
| 정상 외래 혈압의 노인 고혈압 환자에서 가면고혈압의 특징과 예측 인자 |
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박성지1, 박정배2, 최동주3, 윤호중4, 박창규5, 안영근6, 신준한7, 김동운8, 임세중9 |
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성균관대학교 삼성서울병원1, 관동대학교 제일병원2, 분당서울대학교병원3, 가톨릭대학교 서울성모병원4, 고려대학교 구로병원5, 전남대학교병원6, 아주대학교병원7, 전북대학교병원8, 세브란스병원9 |
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| 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. |
| Key Words:
Masked hypertension, Home blood pressure, Elderly hypertension |
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