Masked Hypertension
Masked hypertension refers to hypertension that does not show up during measurements in the doctor's office. Normal values are measured here - however, blood pressure values are in the hypertensive range in everyday life or at work.
Masked hypertension is the classic form of hypertension triggered by stress (stress-induced). During a workday under high stress, elevated blood pressure values occur, even though they respond normally at rest (for example, in the doctor's office) and also during standardized physical exertion. This discrepancy - high blood pressure under mental strain / normal blood pressure response during physical exertion - is characteristic of masked hypertension.
To uncover masked hypertension, the only option is an outpatient long-term blood pressure measurement with a device that is worn over a certain period in everyday life, regularly measures, and records the values, or self-measurement of blood pressure in everyday life.
Elevated blood pressure values during self-measurements can indicate masked hypertension. However, even with high-normal measured values in the practice - especially in younger, leaner individuals - one should be alert. This is particularly true when psychosocial stress factors, alcohol consumption, or smoking are involved. In this constellation, men are more frequently affected by masked hypertension, even if they are slightly overweight. However, masked hypertension can also be present in patients already undergoing treatment for hypertension and can falsely indicate treatment success when blood pressure values are measured normally in the practice.
If typical organ damage attributable to hypertension exists, such as atrial fibrillation, enlargement of an atrium, or enlargement of the left ventricle, an attempt should also be made to uncover any masked hypertension through a long-term blood pressure measurement when normal blood pressure is measured in the practice.
First and foremost in the treatment of masked hypertension as a classic, stress-induced form is stress reduction. Whether medication therapy is necessary depends on the severity of the hypertension. If organ damage is already present, medication therapy will be unavoidable in most cases. However, this does not differ from the treatment of "normal" hypertension.
A study has shown that masked hypertension occurs about twice as often as so-called white coat hypertension, where blood pressure values in practice measurements are elevated compared to everyday values.
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By Sabine Croci.
This article is medically reviewed. Last updated (12/2023).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.
