Masked Hypertension – ABC CARDIOL

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Editorial

Self-Monitoring with or Without Telemonitoring: Is a New Time for Diagnosis and Management Hypertension?

According to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline for the prevention, detection, evaluation, and management of high blood pressure (BP) in adults, 46% of US adults have hypertension (HTN). In Brazil, because the levels of systolic and diastolic BP that define HTN differ from ACC/AHA Guideline, the percentage is about 25%, according to VIGITEL.

HTN is an important public health issue and the major risk factor for heart disease, stroke, and chronic kidney disease. Heart disease and stroke are among the most prevalent and costly health problems worldwide, and controlling BP is the best effective intervention in life-saving, preventing deleterious comorbidities, but only about half of those with HTN have it under control even in developing countries.^,^,

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Original Article

Prevalence of Masked and White-Coat Hypertension in Pre-Hypertensive and Stage 1 Hypertensive patients with the use of TeleMRPA

Weimar Kunz Sebba Barroso et al. Audes Diógenes Magalhães Feitosa Eduardo Costa Duarte Barbosa Roberto Dischinger Miranda … Andréa Araújo Brandão Priscila Valverde Oliveira Vitorino Lúcio Paulo de Souza Ribeiro Marco Mota Gomes

Abstract

Background:

The diagnosis of arterial hypertension based on measurements of blood pressure in the office has low accuracy.

Objective:

To evaluate the prevalence of masked hypertension (MH) and white-coat hypertension through home blood pressure monitoring (HBPM) in pre-hypertensive and stage 1 hypertensive patients.

Method:

Retrospective study, of which sample consisted of individuals with BP ≥ 120/80 mmHg and < 160/100 mmHg at the medical office without the use of antihypertensive medication and who underwent exams on the HBPM platform by telemedicine (TeleMRPA) between May 2017 and September 2018. The four-day MRPA protocol was used, with 24 measurements, using automated, validated, calibrated equipment with a memory function.

Results:

The sample consisted of 1,273 participants, of which 739 (58.1%) were women. The mean age was 52.4 ± 14.9 years, mean body mass index (BMI) 28.4 ± 5.1 kg/m². The casual BP was higher than the HBPM in 7.6 mmHg for systolic blood pressure (SBP) and 5.2 mmHg for diastolic blood pressure (DBP), both with statistical significance (p < 0.001). There were 558 (43.8%) normotensive individuals; 291 (22.9%) with sustained hypertension; 145 (11.4%) with MH and 279 (21.9%) with white-coat hypertension (WCH), with a diagnostic error by casual BP in the total sample in 424 (33.3%) patients. In stage 1 hypertensive individuals, the prevalence of WCH was 48.9%; in prehypertensive patients, the prevalence of MH was 20.6%.

Conclusion:

MH and WCH have a high prevalence rate in the adult population; however, in prehypertensive or stage 1 hypertensive patients, the prevalence is higher. Out-of-office BP measurements in these subgroups should be performed whenever possible to prevent misdiagnosis.

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Special Article

I Brazilian Position Paper on Prehypertension, White Coat Hypertension and Masked Hypertension: Diagnosis and Management

Alexandre Alessi et al. Andréa Araujo Brandão Annelise Machado Gomes de Paiva Armando da Rocha Nogueira … Audes Feitosa Carolina de Campos Gonzaga Celso Amodeo Decio Mion Dilma do Socorro Moraes de Souza Eduardo Barbosa Emilton Lima Junior Fernando Nobre Flavio Dani Fuchs Hilton Chaves Junior Jamil Cherem Schneider João Gemelli José Fernando Villela-Martin Luiz Cesar Nazario Scala Marco Antonio Mota Gomes Marcus Vinicus Bolivar Malachias Nelson Siqueira de Morais Osni Moreira Filho Oswaldo Passarelli Junior Paulo Cesar Brandão Veiga Jardim Roberto Dischinger Miranda Rui Póvoa Sandra Cristina Fuchs Sergio Baiocchi Thiago Veiga Jardim Weimar Kunz Sebba Barroso

Introduction

Arterial blood pressure (BP) is a very useful variable in clinical practice. Its measurement is simple, inexpensive and easy; it is worth noting that BP should be accurately obtained, following the recommendations of the VI Brazilian Guidelines on Hypertension (DBH VI).

Office BP measurement is the central parameter for the diagnosis, treatment and follow-up of systemic arterial hypertension (SAH), being directly, continuously and independently related to the risk of fatal and non-fatal cardiovascular (CV) events ^– .

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Self-Monitoring with or Without Telemonitoring: Is a New Time for Diagnosis and Management Hypertension?

Prevalence of Masked and White-Coat Hypertension in Pre-Hypertensive and Stage 1 Hypertensive patients with the use of TeleMRPA

Abstract

Background:

Objective:

Method:

Results:

Conclusion:

I Brazilian Position Paper on Prehypertension, White Coat Hypertension and Masked Hypertension: Diagnosis and Management

Introduction

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