Masked Hypertension in Diabetes Mellitus: a Potential Risk

Overview

Journal J Clin Hypertens (Greenwich)

Specialty Cardiology & Vascular Diseases

Date 2007 Aug 4

PMID 17673881

Citations 15

Authors

Kazuo Eguchi

Joji Ishikawa

Satoshi Hoshide

Thomas G Pickering

Kazuyuki Shimada

Kazuomi Kario

Affiliations

Soon will be listed here.

Abstract

The prevalence and clinical significance of masked hypertension (MHT) in diabetics have infrequently been described. The authors assessed the association of MHT (defined using a clinic blood pressure [BP] <140/90 mm Hg and daytime ambulatory BP > or = 135/85 mm Hg) with microvascular and macrovascular end organ damage in 81 clinically normotensive Japanese diabetic persons. The prevalence of silent cerebral infarcts (SCIs), increased left ventricular mass, and albuminuria were evaluated. Of 81 patients, 38 (46.9%) were classified as having MHT and showed significantly more SCIs (mean +/- SE: 2.5+/-0.5 vs 1.1+/-0.2; P=.017), and more albuminuria (39% vs 16%; P=.025), but no increase in left ventricular mass index, than the normotensive persons in office and on ambulatory BP monitoring group. The prevalence of MHT in this diabetic population was high (47%). Diabetic patients with MHT showed evidence of brain and kidney damage. Hence, out-of-office monitoring of BP may be indicated in diabetics whose BP is normal in the clinic.

Citing Articles

Masked nocturnal hypertension as a result of high prevalence of non-dippers among apparently well-controlled hypertensive patients with type 2 diabetes mellitus: data from a prospective study.

Calin P, Viorel M, Luchiana P, Mihaela C, Lavinia P Diabetol Metab Syndr. 2022; 14(1):130.

PMID: 36109761 PMC: 9479407. DOI: 10.1186/s13098-022-00899-6.

Hypertensive Phenotypes and Pattern of Ambulatory Blood Pressure in Patients of Diabetes Mellitus of Kashmir Valley.

Bhat T, Mir M, Naqati S, Naik M, Naqash M Indian J Endocrinol Metab. 2022; 26(1):55-60.

PMID: 35662762 PMC: 9162251. DOI: 10.4103/ijem.ijem_226_21.

Validation of Two Automatic Blood Pressure Monitors With the Ability to Transfer Data via Bluetooth.

Wetterholm M, Bonn S, Alexandrou C, Lof M, Trolle Lagerros Y J Med Internet Res. 2019; 21(4):e12772.

PMID: 30994459 PMC: 6492059. DOI: 10.2196/12772.

The measurement of orthostatic blood pressure as a screening tool for masked hypertension with abnormal circadian blood pressure rhythm.

Komori T, Eguchi K, Kario K Hypertens Res. 2016; 39(9):631-2.

PMID: 27307375 DOI: 10.1038/hr.2016.70.

Masked hypertension as an unrecognized destructive condition.

Balta S, Demir M, Kucuk U, Arslan Z, Demirkol S, Unlu M J Clin Hypertens (Greenwich). 2013; 16(2):155.

PMID: 24330197 PMC: 8031529. DOI: 10.1111/jch.12240.

References

Eguchi K, Kario K, Shimada K . Greater impact of coexistence of hypertension and diabetes on silent cerebral infarcts. Stroke. 2003; 34(10):2471-4. DOI: 10.1161/01.STR.0000089684.41902.CD. View

Molitch M, DeFronzo R, Franz M, Keane W, Mogensen C, Parving H . Nephropathy in diabetes. Diabetes Care. 2003; 27 Suppl 1:S79-83. DOI: 10.2337/diacare.27.2007.s79. View

Liu J, Roman M, Pini R, Schwartz J, Pickering T, Devereux R . Cardiac and arterial target organ damage in adults with elevated ambulatory and normal office blood pressure. Ann Intern Med. 1999; 131(8):564-72. DOI: 10.7326/0003-4819-131-8-199910190-00003. View

Palmieri V, Bella J, Arnett D, Liu J, Oberman A, Schuck M . Effect of type 2 diabetes mellitus on left ventricular geometry and systolic function in hypertensive subjects: Hypertension Genetic Epidemiology Network (HyperGEN) study. Circulation. 2001; 103(1):102-7. DOI: 10.1161/01.cir.103.1.102. View

Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J . Prognosis of "masked" hypertension and "white-coat" hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J Am Coll Cardiol. 2005; 46(3):508-15. DOI: 10.1016/j.jacc.2005.03.070. View

. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2003; 27 Suppl 1:S5-S10. DOI: 10.2337/diacare.27.2007.s5. View

Hougaku H, Matsumoto M, Kitagawa K, Harada K, Oku N, Itoh T . Silent cerebral infarction as a form of hypertensive target organ damage in the brain. Hypertension. 1992; 20(6):816-20. DOI: 10.1161/01.hyp.20.6.816. View

Eguchi K, Kario K, Hoshide S, Ishikawa J, Morinari M, Shimada K . Type 2 diabetes is associated with left ventricular concentric remodeling in hypertensive patients. Am J Hypertens. 2005; 18(1):23-9. DOI: 10.1016/j.amjhyper.2004.08.024. View

Flores L, Gimenez M, Esmatjes E . Prognostic significance of the white coat hypertension in patients with type 1 diabetes mellitus. Diabetes Res Clin Pract. 2006; 74(1):21-5. DOI: 10.1016/j.diabres.2006.03.006. View

10.

Felicio J, Ferreira S, Plavnik F, Moises V, Kohlmann Jr O, Ribeiro A . Effect of blood glucose on left ventricular mass in patients with hypertension and type 2 diabetes mellitus. Am J Hypertens. 2000; 13(11):1149-54. DOI: 10.1016/s0895-7061(00)01200-0. View

11.

Eguchi K, Ishikawa J, Hoshide S, Ishikawa S, Shimada K, Kario K . Impact of blood pressure vs. glycemic factors on target organ damage in patients with type 2 diabetes mellitus. J Clin Hypertens (Greenwich). 2006; 8(6):404-10. PMC: 8109584. DOI: 10.1111/j.1524-6175.2006.04739.x. View

12.

Devereux R, Roman M, Paranicas M, OGrady M, Lee E, Welty T . Impact of diabetes on cardiac structure and function: the strong heart study. Circulation. 2000; 101(19):2271-6. DOI: 10.1161/01.cir.101.19.2271. View

13.

Pickering T, Davidson K, Gerin W, Schwartz J . Masked hypertension. Hypertension. 2002; 40(6):795-6. DOI: 10.1161/01.hyp.0000038733.08436.98. View

14.

Okin P, Devereux R, Gerdts E, Snapinn S, Harris K, Jern S . Impact of diabetes mellitus on regression of electrocardiographic left ventricular hypertrophy and the prediction of outcome during antihypertensive therapy: the Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study. Circulation. 2006; 113(12):1588-96. DOI: 10.1161/CIRCULATIONAHA.105.574822. View

15.

Nakano S, Ito T, Furuya K, Tsuda S, Konishi K, Nishizawa M . Ambulatory blood pressure level rather than dipper/nondipper status predicts vascular events in type 2 diabetic subjects. Hypertens Res. 2005; 27(9):647-56. DOI: 10.1291/hypres.27.647. View

16.

Devereux R, Dahlof B, Levy D, Pfeffer M . Comparison of enalapril versus nifedipine to decrease left ventricular hypertrophy in systemic hypertension (the PRESERVE trial). Am J Cardiol. 1996; 78(1):61-5. DOI: 10.1016/s0002-9149(96)00228-7. View

17.

Gross J, de Azevedo M, Silveiro S, Canani L, Caramori M, Zelmanovitz T . Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care. 2004; 28(1):164-76. DOI: 10.2337/diacare.28.1.164. View

18.

Kario K, Sakata T, Higashikawa M, Katayama Y, Hoshide S, Shimada K . Silent cerebral infarcts in basal ganglia are advanced in congenital protein C-deficient heterozygotes with hypertension. Am J Hypertens. 2001; 14(8 Pt 1):818-22. DOI: 10.1016/s0895-7061(01)02046-5. View

19.

Gambardella S, Frontoni S, Spallone V, Maiello M, Civetta E, Lanza G . Increased left ventricular mass in normotensive diabetic patients with autonomic neuropathy. Am J Hypertens. 1993; 6(2):97-102. DOI: 10.1093/ajh/6.2.97. View

20.

Colagiuri S, Cull C, Holman R . Are lower fasting plasma glucose levels at diagnosis of type 2 diabetes associated with improved outcomes?: U.K. prospective diabetes study 61. Diabetes Care. 2002; 25(8):1410-7. DOI: 10.2337/diacare.25.8.1410. View