Abstract P202: Association of Masked Hypertension and Prehypertension with Subclinical Cardiovascular Disease in the Jackson Heart Study
Background: Masked hypertension (MHT), defined as non-elevated clinic blood pressure (CBP) and elevated blood pressure on ambulatory blood pressure (ABP) monitoring (ABPM), and prehypertension (PHT) are individually associated with increased cardiovascular disease (CVD) risk. The degree of diagnostic overlap between PHT and MHT and their associations with subclinical CVD including left ventricular mass index (LVMI) or common carotid intima-media thickness (CCIMT) is poorly characterized among African-Americans (AAs).
Methods: In the Jackson Heart Study (JHS), a large community-based cohort of AAs in Jackson, MS, CBP measurements and 24-hour ABPM were obtained at baseline (2000-2004) using standardized protocols. Analyses were restricted to 391 participants who were not taking antihypertensive medications with complete data for CBP, ABPM, LVMI measured with 2D echocardiography, and CCIMT taken from carotid ultrasound. Clinic hypertension (HTN) was defined as ≥140/90 mmHg. Non-elevated CBP was defined as <140/90 mmHg and includes both PHT (systolic CBP 120-139 mmHg or diastolic CBP 80-89 mmHg) and normal CBP (<120/80 mmHg). MHT was defined as non-elevated CBP and elevated ABP (awake ABP ≥135/85 mmHg).
Results: Of the 391 participants, 74 (18.9%) had HTN. Among the 317 participants with non-elevated CBP, 185 (58.4%) had PHT and 68 (21.5%) had MHT; 68 (21.5%) had MHT (59 in those with PHT, and 9 in those with normal CBP). In a fully-adjusted model (see Table), compared to participants with both PHT and MHT, LVMI and CCIMT was less among participants with non-elevated CBP (including those with normal CBP and PHT) and without MHT. There was no difference in LVMI and CCIMT in individuals with PHT and MHT vs. those with normal CBP and MHT.
Conclusions: For AAs with non-elevated CBP, LVMI and CCIMT were the highest among individuals with MHT, regardless of whether PHT was present. This finding supports using ABPM to detect MHT among AAs with non-elevated CBP.
Author Disclosures: N. Redmond: None. J.N. Booth: None. R.M. Tanner: None. K.M. Diaz: None. M. Abdalla: None. M. Sims: None. P.M. Muntner: None. D. Shimbo: None.
- © 2015 by American Heart Association, Inc.