Recognition and management of masked hypertension: a review and novel approach

J Am Soc Hypertens. 2013 May-Jun;7(3):244-52. doi: 10.1016/j.jash.2013.02.002. Epub 2013 Mar 21.


Failure to show benefit in some cardiovascular and renal outcome trials may be a consequence of masked hypertension, a blood pressure in the hypertensive range outside the office setting. Ambulatory blood pressure monitoring and home blood pressures obtained by the patient are superior to office blood pressure for assessing individual target-organ damage and predicting cardiovascular disease morbidity and mortality. Lastly, masked hypertension is associated with an increased risk of developing primary hypertension and can be treated with either short-acting medications or improvement of underlying causes. We review the clinical impact of masked hypertension on cardiovascular risk and progression of kidney disease. We further propose a clinical management paradigm specific for masked hypertension that needs confirmation in a clinical trial.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Monitoring, Ambulatory
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / prevention & control*
  • Disease Progression
  • Exercise
  • Humans
  • Kidney Diseases / complications
  • Life Style
  • Masked Hypertension / complications
  • Masked Hypertension / diagnosis*
  • Masked Hypertension / drug therapy*
  • Potassium, Dietary
  • Risk Factors
  • Sleep Apnea, Obstructive / complications
  • Smoking / adverse effects
  • Sodium, Dietary
  • Stress, Psychological / complications


  • Antihypertensive Agents
  • Potassium, Dietary
  • Sodium, Dietary