Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension
ABSTRACT Masked hypertension (MH), characterized by normal office blood pressure (OBP) but elevated out‐of‐office readings, carries significant cardiovascular risks comparable to those of sustained hypertension, but remains difficult to detect in clinical practice. This review examines the emerging...
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| Format: | Article |
| Language: | English |
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Wiley
2025-07-01
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| Series: | The Journal of Clinical Hypertension |
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| Online Access: | https://doi.org/10.1111/jch.70077 |
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| author | Chengjie Zhu Yanna Lei Vipin Kumar Xueling Yue Qingsong Cui Xian Wu Cheng |
| author_facet | Chengjie Zhu Yanna Lei Vipin Kumar Xueling Yue Qingsong Cui Xian Wu Cheng |
| author_sort | Chengjie Zhu |
| collection | DOAJ |
| description | ABSTRACT Masked hypertension (MH), characterized by normal office blood pressure (OBP) but elevated out‐of‐office readings, carries significant cardiovascular risks comparable to those of sustained hypertension, but remains difficult to detect in clinical practice. This review examines the emerging evidence on screening for MH, highlighting recent findings from the PAMELA study demonstrating the clinical utility of combined vascular and cardiac assessments for the detection of MH. Particularly noteworthy is the observation that patients with both an elevated cardiac‐ankle vascular index (CAVI) and left ventricular hypertrophy (LVH) or concentric remodeling had a 2.3‐fold increased risk of MH, particularly in men, independent of age and antihypertensive treatment. CAVI offers distinct advantages as a screening parameter due to its independence from blood pressure fluctuations during measurement, its established prognostic value for cardiovascular outcomes, and its high reproducibility in primary care. We propose a stepwise screening approach, prioritizing CAVI assessment in patients with normal OBP but multiple cardiovascular risk factors, followed by echocardiographic assessment in those with elevated CAVI values. This strategy may facilitate earlier detection of MH, allowing timely intervention to reduce cardiovascular morbidity and mortality, although further validation in different age groups and cost‐effectiveness analyses are warranted. |
| format | Article |
| id | doaj-art-d21cb30d9a104c3dafad5cc0e620bcf6 |
| institution | DOAJ |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-d21cb30d9a104c3dafad5cc0e620bcf62025-08-20T03:13:44ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-07-01277n/an/a10.1111/jch.70077Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked HypertensionChengjie Zhu0Yanna Lei1Vipin Kumar2Xueling Yue3Qingsong Cui4Xian Wu Cheng5Intensive Care Unit Yanbian University Hospital Yanji Jilin P.R. ChinaIntensive Care Unit Yanbian University Hospital Yanji Jilin P.R. ChinaDepartment of Cardiology and Hypertension Jilin Provincial Key Laboratory of Stress and Cardiovascular Disease Yanbian University Hospital Yanji Jilin P.R. ChinaDepartment of Cardiology and Hypertension Jilin Provincial Key Laboratory of Stress and Cardiovascular Disease Yanbian University Hospital Yanji Jilin P.R. ChinaIntensive Care Unit Yanbian University Hospital Yanji Jilin P.R. ChinaDepartment of Cardiology and Hypertension Jilin Provincial Key Laboratory of Stress and Cardiovascular Disease Yanbian University Hospital Yanji Jilin P.R. ChinaABSTRACT Masked hypertension (MH), characterized by normal office blood pressure (OBP) but elevated out‐of‐office readings, carries significant cardiovascular risks comparable to those of sustained hypertension, but remains difficult to detect in clinical practice. This review examines the emerging evidence on screening for MH, highlighting recent findings from the PAMELA study demonstrating the clinical utility of combined vascular and cardiac assessments for the detection of MH. Particularly noteworthy is the observation that patients with both an elevated cardiac‐ankle vascular index (CAVI) and left ventricular hypertrophy (LVH) or concentric remodeling had a 2.3‐fold increased risk of MH, particularly in men, independent of age and antihypertensive treatment. CAVI offers distinct advantages as a screening parameter due to its independence from blood pressure fluctuations during measurement, its established prognostic value for cardiovascular outcomes, and its high reproducibility in primary care. We propose a stepwise screening approach, prioritizing CAVI assessment in patients with normal OBP but multiple cardiovascular risk factors, followed by echocardiographic assessment in those with elevated CAVI values. This strategy may facilitate earlier detection of MH, allowing timely intervention to reduce cardiovascular morbidity and mortality, although further validation in different age groups and cost‐effectiveness analyses are warranted.https://doi.org/10.1111/jch.70077arterial stiffnesscardio‐ankle vascular indexleft ventricular remodelingmasked hypertension |
| spellingShingle | Chengjie Zhu Yanna Lei Vipin Kumar Xueling Yue Qingsong Cui Xian Wu Cheng Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension The Journal of Clinical Hypertension arterial stiffness cardio‐ankle vascular index left ventricular remodeling masked hypertension |
| title | Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension |
| title_full | Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension |
| title_fullStr | Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension |
| title_full_unstemmed | Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension |
| title_short | Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension |
| title_sort | hidden cardiovascular risk arterial stiffness and left ventricular remodeling as potential indicators of masked hypertension |
| topic | arterial stiffness cardio‐ankle vascular index left ventricular remodeling masked hypertension |
| url | https://doi.org/10.1111/jch.70077 |
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