Thursday, June 26, 2014

Million Hearts Colorado: Masked Hypertension Considerable, Even Among Treated Patients

High blood pressure, also known as hypertension, is a major risk factor for cardiovascular disease (CVD), the leading cause of death for adults in the United States.

The term “masked hypertension” describes people who have a normal seated blood pressure (BP) when measured in the clinic but have an elevated BP outside of the clinic according to ambulatory BP monitoring (ABPM) or home BP monitoring. Research shows that patients with masked hypertension are at high risk for developing CVD because their condition often remains undetected and untreated.

A recent study examined the prevalence of masked uncontrolled hypertension (MUCH) in people with treated and seemingly well-controlled BP. The acronym “MUCH” describes patients who are treated for hypertension and have controlled clinic BP (i.e., less than 140/90 mmHg) but who have uncontrolled BP outside of a clinical setting, finding that the proportion of MUCH among treated hypertensive patients was 31.1%, based on 24-hour ABPM criteria (i.e., greater than or equal to a systolic BP of 130 mmHg and/or a diastolic BP of 80 mmHg).

The results from this study suggest that almost one-third of people who are considered to have adequate BP control based on conventional clinical criteria may not have their BP controlled when assessed regularly outside the clinic. Relying on clinic BP alone is not sufficient to improve BP control because many patients (especially higher risk individuals) have elevated nighttime BP.

Study authors suggest that primary care physicians should consider more routine use of ABPM in patients with borderline clinic BP and high CVD risk.

Read the Science-In-Brief here.

High blood pressure management is a key strategy of the  Million Hearts Initiative, an effort to prevent 1 million heart attacks and strokes over five years.  Colorado participates in this initiative and you can too. Be one in a million - make your commitment and pledge today.

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