Purpose: To determine the differences in echocardiographic (ECHO) left ventricular mass (LVM) in patients with masked hypertension, hypertension, normotension and white coat hypertension as determined by 24hr ambulatory blood pressure monitoring (ABPM).
Methods: Our cardiology database was searched for all P who had both an ABPM and an ECHO. 8,304 P had both examinations. We excluded P with an EF of 16mmHg and P with a mitral regurgitant orifice area by PISA of >2.0cm2. 5,778 P remained after these exclusions. Of the remaining ECHO we selected only those P whose ECHO and ABPM were performed within 1 year of each other. This left 2,051 P for analysis. One way ANOVA was used to determine significance between all means and Tukey-Kramer comparisons test between groups.
Results: 50% of P were hypertensive, 23% had white coat hypertension, 19% were normotensive and 3% had masked hypertension. The major results are seen in Table 1.
Conclusions: There was no statistically significant difference in LVM between masked hypertensive and hypertensive P. Similarly, there was no statistically significant difference in LVM between normotensive and white coat hypertensive P. The LV mass for hypertensives is statistically significantly greater than in normotensive and white coat hypertensive P. Although the same cannot be said, statistically, for the masked hypertensive P we believe this is due to insufficient numbers in the masked hypertensive group. These data provide compelling support to suggest that the risks of the masked hypertensive population are likely similar to the hypertensive population. We advocate either 24hr ABPM or home BP monitoring to establish a diagnosis of masked hypertension.