Peacock J, Diaz K M, Viera A J, Schwartz J E, Shimbo D
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY, USA.
Department of Family Medicine and Hypertension Research Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Hum Hypertens. 2014 Sep;28(9):521-8. doi: 10.1038/jhh.2014.9. Epub 2014 Feb 27.
'Masked hypertension' is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15-30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared with sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment and areas for future research.
“隐匿性高血压”的定义为诊所血压（BP）未升高但诊室外平均血压升高，通常通过动态血压监测来确定。在诊所血压未升高的成年人中，约15% - 30%患有隐匿性高血压。与持续性血压正常（诊所和动态血压均未升高）相比，隐匿性高血压与心血管疾病发病率和死亡率增加相关，这与持续性高血压（诊所和动态血压均升高）的风险相似或接近。心血管风险增加且无法通过传统的诊所血压测量方法诊断，这使得隐匿性高血压成为一个重大的公共卫生问题。然而，许多重要问题仍然存在。首先，不同研究中隐匿性高血压的定义各不相同。此外，临床环境中排除隐匿性高血压的最佳方法也尚不清楚。在识别隐匿性高血压方面，家庭血压监测是否足以替代动态血压监测尚不清楚。很少有研究探讨可能解释隐匿性高血压的机制途径。最后，关于治疗隐匿性高血压患者的最佳方法的数据也很少。在此，我们综述了有关隐匿性高血压的当前文献，包括定义、患病率、临床意义、特殊患者群体、相关因素、与诊断和治疗相关的问题以及未来研究领域。
