Masked Hypertension — EECC MCQ

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EasyHypertension & Preventive CardiologyMasked HypertensionEECC

A 50-year-old man has normal office BP readings (128/78 mmHg) but his GP arranges ABPM due to target organ damage (LVH on ECG). The 24-hour ABPM average is 138/88 mmHg with daytime average 142/90 mmHg. What is this phenomenon called?

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Correct answer: C — Masked hypertension

Masked hypertension occurs when office BP is normal but out-of-office BP (ABPM or HBPM) is elevated. It affects approximately 10-15% of the population and is associated with a cardiovascular risk similar to or higher than sustained hypertension, as it often goes undetected and untreated. The 2024 ESC Hypertension Guidelines recommend out-of-office BP measurement when there is a discrepancy between office BP and the presence of target organ damage (such as LVH, microalbuminuria, or retinopathy). Masked hypertension requires treatment as for sustained hypertension.

Reference: ESC (2024): Guidelines for the Management of Elevated Blood Pressure and Hypertension