Masked hypertension in chronic kidney disease raises kidney damage, cardiovascular damage risk: Study

By: Dr. Victor Marchione | Blood Pressure | Monday, March 21, 2016 - 12:00 PM

Masked hypertension in chronic kidney diseaseMasked hypertension in chronic kidney disease raises kidney damage and cardiovascular damage risk. A recent study found that hypertension in chronic kidney disease can often go undetected in clinical settings. This can pose a risk to patients as it can increase the risk of kidney, heart, and vascular damage.

Numerous studies have shown that measuring blood pressure in a non-clinical setting is much more effective for determining hypertension risk than measuring blood pressure in a doctor’s office. But these studies were conducted in patients with normal kidney function.

The new study found that 28 percent of participants had masked hypertension, meaning their hypertension was not seen in clinical settings, but their pressure was high outside the clinic. High blood pressure in non-clinical setting increases the risk for kidney, heart, and vascular damage.

Lead researcher Dr. Paul Drawz said, “Our findings support the recommendations that patients check their blood pressure outside the usual doctor’s office setting, either by 24-hour blood pressure monitoring as done in our study, or by monitoring blood pressure at home. Of course, patients should discuss their blood pressure and its treatment with their doctor.”

Masked hypertension measurements higher at home than at clinic

Discrepancies in blood pressure between clinic setting and at-home environment may be explained by the fact that a patient’s anxiety may get lower in the presence of a doctor, thus contributing to masked hypertension. When a patient is in their normal environment at work or at home, their anxiety and everyday stresses may be higher, thus revealing higher blood pressure.

“White coat hypertension” is a condition in which blood pressure is higher in a clinic environment because a person is more anxious in the presence of a doctor. This phenomenon is well studied and far more understood than the reverse. A study published in the Journal of the American College of Cardiology showed that although patients may show normal blood pressure levels in the clinic, their at-home readings may be what puts them at risk for hypertension-related complications.

Dr. Praveen Veerabhadrappa from Philadelphia’s Temple University said, “Masked hypertension is known to be a precursor of sustained hypertension. The prevalence of masked hypertension is known to be as high as 70 percent in African Americans, a rate that is significantly higher than the approximate 10 percent reported in the general population.”

Regular monitoring of blood pressure at home can give doctors a better idea of a patient’s risk of hypertension complications as they can keep record of their numbers to reveal if treatment for hypertension is required.

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