Masked Hypertension
Masked hypertension refers to high blood pressure that doesnt show up when measured in the doctors office. Readings there are normal, while blood pressure in everyday life or at work is in the high range.
Masked hypertension is the classic stress-related form of high blood pressure. Elevated readings occur during a stressful workday, even though blood pressure is normal at rest (for example in the doctors office) and also responds normally to standardized physical exertion. This mismatch high blood pressure with mental stress but a normal blood pressure response during physical strain is typical for masked hypertension.
The only way to uncover masked hypertension is usually ambulatory long-term blood pressure monitoring with a device worn during daily life that takes repeated measurements and records them, or regular home blood pressure monitoring.
Raised readings during home measurements can point to masked hypertension. But you should also be alert if office readings are high-normal especially in younger, leaner people. This is particularly true when psychosocial stress, alcohol use, or smoking are present. In that situation men are more often affected by masked hypertension, even if they are only slightly overweight. Masked hypertension can also occur in people already being treated for high blood pressure and may if office readings are normal give the false impression that treatment is successful.
If there are typical signs of organ damage that can be caused by high blood pressure for example atrial fibrillation, enlargement of an atrium, or enlargement of the left heart chamber a 24-hour or ambulatory blood pressure measurement should also be tried to unmask a possible masked hypertension, even if office blood pressure is normal.
The main approach to treating masked hypertension, as the classic stress-induced form, is to reduce stress. Whether medication is needed depends on how severe the high blood pressure is. If organ damage is already present, medication will usually be necessary. The drug treatment itself does not differ from treatment for ordinary high blood pressure.
One study showed that masked hypertension occurs about twice as often as so-called white-coat hypertension, where office readings are higher than everyday readings.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
