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Clinical features and predictors of masked uncontrolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry
- Title
- Clinical features and predictors of masked uncontrolled hypertension from the Korean Ambulatory Blood Pressure Monitoring Registry
- Authors
- Kim, Hyun-Jin; Shin, Jeong-Hun; Lee, Yonggu; Kim, Ju Han; Hwang, Sun Ho; Kim, Woo Shik; Park, Sungha; Rhee, Sang Jae; Lee, Eun Mi; Ihm, Sang Hyun; Pyun, Wook Bum; Shin, Jinho
- Ewha Authors
- 편욱범
- SCOPUS Author ID
- 편욱범
- Issue Date
- 2021
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- ISSN
- 1226-3303
2005-6648
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE vol. 36, no. 5, pp. 1102 - +
- Keywords
- Masked uncontrolled hypertension; Blood pressure monitoring; ambulatory; Blood pressure
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Indexed
- SCIE; KCI
- Document Type
- Article
- Abstract
- Background/Aims: The clinical characteristics of patients with masked uncontrolled hypertension (MUCH) have been poorly defined, and few studies have investigated the clinical predictors of MUCH. We investigated the demographic, clinical, and blood pressure (BP) characteristics of patients with MUCH and proposed a prediction model for MUCH in patients with hypertension. Methods: We analyzed 1,986 subjects who were enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) Registry and taking antihypertensive drugs, and classified them into the controlled hypertension (n = 465) and MUCH (n = 389) groups. MUCH was defined as the presence of a 24-hour ambulatory mean systolic BP >= 130 mmHg and/or diastolic BP >= 80 mmHg in patients treated with antihypertensive drugs, having normal office BP. Results: Patients in the MUCH group had significantly worse metabolic profiles and higher office BP, and took significantly fewer antihypertensive drugs compared to those in the controlled hypertension group. Multivariate logistic regression analyses identified high office systolic BP and diastolic BP, prior stroke, dyslipidemia, left ventricular hypertrophy (LVH, >= 116 g/m(2) for men, and >= 96 g/m(2) for women), high heart rate (>= 75 beats/min), and single antihypertensive drug use as independent predictors of MUCH. A prediction model using these predictors showed a high diagnostic accuracy (C-index of 0.839) and goodness-of-fit for the presence of MUCH. Conclusions: MUCH is associated with a high-normal increase in office BP and underuse of antihypertensive drugs, as well as dyslipidemia, prior stroke, and LVH, which could underscore achieving optimal BP control. The proposed model accurately predicts MUCH in patients with controlled office BP.
- DOI
- 10.3904/kjim.2020.650
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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