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KMID : 0828520100140020070
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Journal of the Korean Geriatrics Society
2010 Volume.14 No. 2 p.70 ~ p.76
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Characteristics and Predictors of Masked Hypertension in Elderly Patients with Well-controlled Hypertension
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Park Sung-Ji
Park Jeong-Bae
Choi Dong-Ju
Youn Ho-Joong
Park Chang-Gyu
Ahn Young-Keun
Shin Joon-Han
Kim Dong-Woon
Rim Se-Joong
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Abstract
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Background: Clinic-based blood pressure measurements may lead to untoward results in the management of hyperten- sion. 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.
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KEYWORD
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Masked hypertension, Home blood pressure, Elderly hypertension
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