LAUSR

Objective: In addition to standard office blood pressure measurements (OBPM) home blood pressure measurements (HBPM) and ambulatory blood pressure measurements (ABPM) enable detection of subjects with normal office, but elevated out-of-office blood pressure. This entity of hypertension, known as masked hypertension, has a high estimated prevalence in the European general population. Masked hypertension is associated not only with an increased risk of sustained hypertension, but also with higher cardiovascular morbidity and mortality. However, to date studies comparing the two out-of-office methods in detecting masked hypertension in the general population are scarce. Therefore, the objective of our study was to compare the effectiveness of HBPM and ABPM in diagnosing masked hypertension in a Slovenian population sample. Design and method: A random population sample was recruited from the Municipality of Ribnica in southern Slovenia. All subjects had OBPM (averaged 3 consecutive measurements), HBPM during 3 consecutive days (averaged 12 measurements) and 24 h ABPM. An OBPM cutoff value of < 140/90 mmHg was used to identify in-office normotensive participants. Of these, subjects with an average HBPM or awake ABPM > 135/85 mmHg were considered having masked hypertension. Results: A total of 128 participants (53.1% women; mean age 34.7 ± 5.18 years, not treated for hypertension) with successful OBPM, HBPM and ABPM were included in the analysis. Based on OBPM, 107 subjects were defined as in-office normotensives. Among these, using HBPM we identified 8 (7.48%) participants with masked hypertension and 99 (92.5%) participants with mean out-of-office blood pressure in the normotensive range. With ABPM we re-classified 14 (13.1%) HBPM normotensive subjects as having masked hypertension. Additionally, 5 (4.67%) HBPM masked hypertensives were defined as normotensive based on ABPM. Overall, the estimated prevalence of masked hypertension was 7.48% based on HBPM, and 15.9% based on ABPM. Conclusions: In a random Slovenian general population sample of young adults the prevalence of masked hypertension according to HBPM was estimated to be >7%. Using ABPM in the same population sample the prevalence increased to approximately 16%.