Nocturnal masked hypertension tied to higher mortality risk

A recent study has found that in patients with masked hypertension, the mortality risk is not the same for all subtypes and entails night-time blood pressure (BP) elevation, either isolated or with daytime elevation. On the other hand, daytime masked hypertension does not appear to significantly contribute to an increased risk of death.

Compared with patients with normal office and 24-h BP, those with isolated daytime masked hypertension showed no significantly elevated risk of mortality in models adjusted for clinical confounders (hazard ratio [HR], 1.07, 95 percent confidence interval [CI], 0.80–1.43).

Conversely, individuals with isolated night-time masked hypertension (HR, 1.39, 95 percent CI, 1.19–1.63) and daytime and night-time masked hypertension (HR, 1.22, 95 percent CI, 1.08–1.37) were at higher risk of death than those with BP in the normal range.

These results were consistent for cardiovascular death.

Overall, 4,999 patients with masked hypertension (normal office BP and elevated 24-h BP) were included in this study. These participants were divided into the following groups: isolated daytime masked hypertension (elevated daytime BP and normal night-time BP, n=800), isolated night-time masked hypertension (elevated night-time BP and normal daytime BP, n=1,069), and daytime and night-time masked hypertension (elevation of both daytime and night-time-BP, n=2,989).

The authors assessed all-cause and cardiovascular death over a median follow-up of 9.7 years in each of the subtypes compared with 10,006 patients with normal office and 24-h BP. They estimated HRs using Cox models adjusted for clinical confounders.