This Article Full Text Full Text (PDF) All Versions of this Article: 54/2/217    most recent HYPERTENSIONAHA.109.132936v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Messerli, F. H. Articles by Makani, H. PubMed PubMed Citation Articles by Messerli, F. H. Articles by Makani, H. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Other hypertension Clinical Studies Related Article

(Hypertension. 2009;54:217.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Relentless Progression Toward Sustained Hypertension

Franz H. Messerli; Harikrishna Makani

From the Division of Cardiology, St Luke’s-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York, NY.

Correspondence to Franz H. Messerli, Division of Cardiology, St Luke’s Roosevelt Hospital Center, 1000 10th Ave, Suite 3B.30, New York, NY 10019. E-mail FMesserli@aol.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Blood pressure (BP) measured carefully by cuff under standardized conditions in physician offices has been shown to be an acceptable predictor of morbidity and mortality.¹ However, 24-hour ambulatory BP monitoring is a closer surrogate end point for heart attack and stroke than office BP.^2,3 Because the correlation between 24-hour ambulatory BP measurement and office BP measurement is moderate at best, not unexpectedly there will be a significant number of people who are truly hypertensive but in whom the diagnosis is missed by office BP measurements (masked hypertension). Conversely, BP may be elevated in the office but not on ambulatory BP monitoring, an entity known to most clinicians as white-coat hypertension.

Both masked hypertension and white-coat hypertension can be considered prehypertensive states not uncommonly evolving into sustained hypertension. The article by Mancia et al⁴ in the present issue of Hypertension assesses the risk of developing sustained hypertension in the Pressioni Arteriose Monitorate e Loro Associazioni population over a 10-year follow-up. Regardless of whether the definition of white-coat hypertension or masked hypertension was based on home BP measurements or 24-hour ambulatory monitoring, both forms of hypertension were at an increased risk of progressing to sustained hypertension. In fact, Mancia et al⁴ showed that >40% of patients having white-coat or masked hypertension will developed sustained hypertension over a 10-year period (Figure). In contrast, only 16% of truly normotensive subjects will progress to sustained hypertension within the same time span. Of note, both true normotensives and true hypertensive patients had the highest . . . [Full Text of this Article]

Related Article:

Long-Term Risk of Sustained Hypertension in White-Coat or Masked Hypertension

Giuseppe Mancia, Michele Bombelli, Rita Facchetti, Fabiana Madotto, Fosca Quarti-Trevano, Hernan Polo Friz, Guido Grassi, and Roberto Sega
Hypertension 2009 54: 226-232. [Abstract] [Full Text] [PDF]