Clinical features and predictors of masked uncontrolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry
- 주제(키워드) Masked uncontrolled hypertension , Blood pressure monitoring , ambulatory , Blood pressure
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kim, Hyun-Jin; Shin, Jeong-Hun; Lee, Yonggu; Shin, Jinho] Hanyang Univ, Coll Med, Div Cardiol, Dept Internal Med, Seoul, South Korea; [Kim, Ju Han] Chonnam Natl Univ Hosp, Gwangju, South Korea; [Hwang, Sun Ho] Gwangju Vet Hosp, Gwangju, South Korea; [Kim, Woo Shik] Kyung Hee Univ, Med Ctr, Seoul, South Korea; [Park, Sungha] Yonsei Univ, Severance Cardiovasc Hosp, Coll Med, Seoul, South Korea; [Rhee, Sang Jae] Wonkwang Univ Hosp, Iksan, South Korea; [Lee, Eun Mi] Wonkwang Univ, Sanbon Hosp, Gunpo, South Korea; [Ihm, Sang Hyun] Catholic Univ Korea, Coll Med, Seoul, South Korea; [Pyun, Wook Bum] Ewha Womans Univ, Seoul Hosp, Seoul, South Korea
- 등재 SCIE, KCI등재
- OA유형 gold, Green Published
- 발행기관 KOREAN ASSOC INTERNAL MEDICINE
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000183614
- 본문언어 영어
- Published As http://dx.doi.org/10.3904/kjim.2020.650
- PubMed https://pubmed.ncbi.nlm.nih.gov/34134467
초록/요약
Background/Aims: The clinical characteristics of patients with masked uncontrolled hypertension (MUCH) have been poorly defined, and few studies have investigated the clinical predictors of MUCH. We investigated the demographic, clinical, and blood pressure (BP) characteristics of patients with MUCH and proposed a prediction model for MUCH in patients with hypertension. Methods: We analyzed 1,986 subjects who were enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) Registry and taking antihypertensive drugs, and classified them into the controlled hypertension (n = 465) and MUCH (n = 389) groups. MUCH was defined as the presence of a 24-hour ambulatory mean systolic BP >= 130 mmHg and/or diastolic BP >= 80 mmHg in patients treated with antihypertensive drugs, having normal office BP. Results: Patients in the MUCH group had significantly worse metabolic profiles and higher office BP, and took significantly fewer antihypertensive drugs compared to those in the controlled hypertension group. Multivariate logistic regression analyses identified high office systolic BP and diastolic BP, prior stroke, dyslipidemia, left ventricular hypertrophy (LVH, >= 116 g/m(2) for men, and >= 96 g/m(2) for women), high heart rate (>= 75 beats/min), and single antihypertensive drug use as independent predictors of MUCH. A prediction model using these predictors showed a high diagnostic accuracy (C-index of 0.839) and goodness-of-fit for the presence of MUCH. Conclusions: MUCH is associated with a high-normal increase in office BP and underuse of antihypertensive drugs, as well as dyslipidemia, prior stroke, and LVH, which could underscore achieving optimal BP control. The proposed model accurately predicts MUCH in patients with controlled office BP.
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