Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland.
J Hypertens. 2011 Oct;29(10):1880-8. doi: 10.1097/HJH.0b013e32834a98ba.
Home blood pressure (BP) measurement has allowed the identification of individuals with normal office and elevated out-of-office BP (masked hypertension). It is, however, not feasible to measure home BP on all office normotensive individuals. The objective of the present study was to identify demographic, lifestyle, clinical and psychological characteristics suggestive of masked hypertension.
Study population was drawn from the participants of a multidisciplinary epidemiological survey, the Health 2000 Study. The untreated nationwide population sample (n = 1459, age 45-74 years) underwent office (duplicate measurements on one visit) and home (duplicate measurements on 7 days) BP measurements and risk factor evaluation. Psychometric tests assessed psychological distress, hypochondriasis, depression and alexithymia. Masked hypertension was defined as normal office BP (<140/90 mmHg) with elevated home BP (≥135/85 mmHg).
The prevalence of masked hypertension was 8.1% in the untreated Finnish adult population. The cardiovascular risk profile of masked hypertensive patients resembled that of sustained hypertensive patients. High-normal systolic and diastolic office BP, older age, greater BMI, current smoking, excessive alcohol consumption, diabetes and electrocardiographic left-ventricular hypertrophy were independent determinants of masked hypertension in multivariate logistic regression analysis. Masked hypertension was also independently associated with hypochondria.
Masked hypertension is a common phenomenon in an untreated adult population. Physicians should consider home BP measurement if a patient has high-normal office BP, diabetes, left-ventricular hypertrophy, or several other conventional cardiovascular risk factors.
家庭血压（BP）测量使人们能够识别出办公室血压正常但办公室外血压升高的人群（隐匿性高血压）。然而，不可能对所有办公室血压正常的个体进行家庭 BP 测量。本研究的目的是确定提示隐匿性高血压的人口统计学、生活方式、临床和心理特征。
研究人群来自多学科流行病学调查“健康 2000 研究”的参与者。未经治疗的全国人口样本（n=1459，年龄 45-74 岁）接受了办公室（一次就诊时重复测量）和家庭（7 天内重复测量）血压测量以及危险因素评估。心理测试评估了心理困扰、疑病症、抑郁和述情障碍。隐匿性高血压定义为办公室血压正常（<140/90mmHg）伴家庭血压升高（≥135/85mmHg）。
未经治疗的芬兰成年人群中隐匿性高血压的患病率为 8.1%。隐匿性高血压患者的心血管风险特征与持续性高血压患者相似。在多变量逻辑回归分析中，高正常收缩压和舒张压、年龄较大、体重指数较高、当前吸烟、过量饮酒、糖尿病和心电图左心室肥厚是隐匿性高血压的独立决定因素。隐匿性高血压也与疑病症独立相关。
隐匿性高血压在未经治疗的成年人群中很常见。如果患者的办公室血压高正常值、糖尿病、左心室肥厚或其他几个常规心血管危险因素，医生应考虑进行家庭 BP 测量。
