BACKGROUND: Masked uncontrolled hypertension (MUCH), that is, non-hypertensive clinic but high out-of-office blood pressure (BP) in treated patients is at increased cardiovascular risk than controlled hypertension (CH), that is, non-hypertensive clinic and out-of-office BP. Using ambulatory BP, MUCH can be defined as daytime and/or nighttime and/or 24-hour BP above thresholds. It is unclear whether different definitions of MUCH have similar prognostic information. This study assessed the prognostic value of MUCH defined by different ambulatory BP criteria. METHODS: Cardiovascular events were evaluated in 738 treated hypertensive patients with non-hypertensive clinic BP. Among them, participants were classified as having CH or daytime MUCH (BP >135/85 mm Hg) regardless of nighttime BP (Group 1), nighttime MUCH (BP >120/70 mm Hg) regardless of daytime BP (Group 2), 24-hour MUCH (BP >130/80 mm Hg) regardless of daytime or nighttime BP (Group 3), daytime MUCH only (Group 4), nighttime MUCH only (Group 5) and daytime + nighttime MUCH (Group 6). RESULTS: We detected 215 (29%), 357 (48.5%), 275 (37%), 42 (5.5%),184 (25%) and 173 (23.5%) patients with MUCH from Group 1 to 6, respectively. During the follow-up (10 ± 5 years), 148 events occurred in patients with CH and MUCH. After adjustment for covariates, compared to patients with CH, the adjusted hazard ratio (95% confidence interval) for cardiovascular events was 2.01 (1.45-2.79), 1.53 (1.09-2.15), 1.69 (1.22-2.34), 1.52 (0.80-2.91), 1.15 (0.74-1.80) and 2.29 (1.53-3.42) from Group 1 to 6, respectively. CONCLUSIONS: The prognostic impact of MUCH defined according to various ambulatory BP definitions may be different.
BACKGROUND: Masked uncontrolled hypertension (MUCH), that is, non-hypertensive clinic but high out-of-office blood pressure (BP) in treated patients is at increased cardiovascular risk than controlled hypertension (CH), that is, non-hypertensive clinic and out-of-office BP. Using ambulatory BP, MUCH can be defined as daytime and/or nighttime and/or 24-hour BP above thresholds. It is unclear whether different definitions of MUCH have similar prognostic information. This study assessed the prognostic value of MUCH defined by different ambulatory BP criteria. METHODS: Cardiovascular events were evaluated in 738 treated hypertensivepatients with non-hypertensive clinic BP. Among them, participants were classified as having CH or daytime MUCH (BP >135/85 mm Hg) regardless of nighttime BP (Group 1), nighttime MUCH (BP >120/70 mm Hg) regardless of daytime BP (Group 2), 24-hour MUCH (BP >130/80 mm Hg) regardless of daytime or nighttime BP (Group 3), daytime MUCH only (Group 4), nighttime MUCH only (Group 5) and daytime + nighttime MUCH (Group 6). RESULTS: We detected 215 (29%), 357 (48.5%), 275 (37%), 42 (5.5%),184 (25%) and 173 (23.5%) patients with MUCH from Group 1 to 6, respectively. During the follow-up (10 ± 5 years), 148 events occurred in patients with CH and MUCH. After adjustment for covariates, compared to patients with CH, the adjusted hazard ratio (95% confidence interval) for cardiovascular events was 2.01 (1.45-2.79), 1.53 (1.09-2.15), 1.69 (1.22-2.34), 1.52 (0.80-2.91), 1.15 (0.74-1.80) and 2.29 (1.53-3.42) from Group 1 to 6, respectively. CONCLUSIONS: The prognostic impact of MUCH defined according to various ambulatory BP definitions may be different.
Authors: Aicha Hamoudi; Asma Ben Abdelaziz; Sarra Melki; Donia Ben Hassine; Nabila Ben Rejeb; Asma Omezzine; Ali Bouslama; Ahmed Ben Abdelaziz Journal: Tunis Med Date: 2022 fevrier
Authors: Ramón C Hermida; Michael H Smolensky; Horia Balan; Richard J Castriotta; Juan J Crespo; Yaron Dagan; Sherine El-Toukhy; José R Fernández; Garret A FitzGerald; Akio Fujimura; Yong-Jian Geng; Ramón G Hermida-Ayala; Antonio P Machado; Luiz Menna-Barreto; Artemio Mojón; Alfonso Otero; R Daniel Rudic; Eva Schernhammer; Carsten Skarke; Tomoko Y Steen; Martin E Young; Xiaoyun Zhao Journal: Chronobiol Int Date: 2020-12-20 Impact factor: 3.749