Masked hypertension: What you need to know

People with hypertension are usually diagnosed during regular physical checkups, when their blood pressure tests repeatedly reveal a systolic reading (the upper number) of 140 or higher and a diastolic reading (the lower number) of 90 or above. But for a smaller percentage of patients with high blood pressure, the condition is much more difficult to diagnose, reports Newsmax Health.

When we think of high blood pressure, we typically think of sustained hypertension – the type that readily shows up during a routine doctor’s exam. Medication and lifestyle changes are recommended to bring the condition under control. But there are other forms of hypertension as well. For instance, some patients whose blood pressure is ordinarily within normal limits experience a spike in their numbers during checkups – possibly out of anxiety over being around the doctor.

“This is called the white-coat hypertension phenomenon,” explains Samuel J. Mann, M.D., a professor of clinical medicine at New York Presbyterian Hospital, Weill Cornell Medical Center, and author of Hypertension and You. “It affects about 20 percent of hypertension patients.” Although white-coat hypertension usually requires no immediate medical treatment, patients should still be monitored.

“It’s arguable whether people with white-coat hypertension are at risk of developing cardiac issues, but they are at risk for sustained hypertension,” Dr. Mann tells Newsmax Health.

Then there’s a third type of high blood pressure that often goes unnoticed: masked hypertension. This variety, which affects between 4 to 10 percent of all high blood pressure cases, is harder to detect because of its very nature: Patients have normal readings at the doctor’s office, but see higher numbers when they test their blood pressure at home. Studies indicate that masked hypertension is more common among older men, and it’s associated with a greater risk of heart disease.

To detect masked hypertension, a doctor will often recommend wearing an ambulatory blood pressure monitor for 24 hours. The machine does regular readings throughout the day to get an accurate picture of the patient’s average blood pressure measurements.

Is there a way to diagnose hidden hypertension more easily at the doctor’s office? In one small study, patients had their blood pressure measured twice, holding their breath for 30 seconds just before having the second test taken. Patients with masked hypertension were more likely to see higher numbers on the second test.

“The more measurements you do, the more accurate a reading you get,” says Dr. Mann. “And the breath-holding may have taken the patients’ minds off their blood pressure and relaxed them enough to get a true reading.”

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