Prevalence, determinants, and clinical significance of masked hypertension and white-coat hypertension in patients with chronic kidney disease

Nephrology (Carlton). 2016 Oct;21(10):841-50. doi: 10.1111/nep.12672.


Background: Masked hypertension and white-coat hypertension have been studied among the general population and in hypertensive patients. However, little insight is available on masked and white-coat hypertension among patients with chronic kidney disease (CKD).

Methods: We recruited 1322 CKD patients admitted to our hospital division. Patients were divided into four groups: normotension; white-coat hypertension (WCHT); masked hypertension (MHT); sustained hypertension. Multivariable logistic regression analyses were used to evaluate the correlation between WCHT, MHT and renal/cardiovascular parameters.

Results: The prevalence of WCHT and MHT was 10.21% and 16.11%, respectively. Patients with WCHT and MHT had more severe target-organ damage (TOD) than patients with normotension, but had less severe TOD than patients with sustained hypertension. MHT correlated with impaired renal function and left-ventricular hypertrophy, whereas WCHT was associated with abnormal carotid intima media thickness. Age, body mass index, clinic and 24-h systolic blood pressure correlated with MHT, whereas clinic, 24-h diastolic blood pressure and night-time systolic blood pressure was associated with WCHT.

Conclusions: Prevalence of WCHT and MHT was 10.21% and 16.11%, respectively. WCHT and MHT show a close relationship with TOD in CKD patients.

Keywords: ambulatory blood pressure monitoring; chronic kidney disease; masked hypertension; white coat hypertension.

MeSH terms

  • Adult
  • Blood Pressure Monitoring, Ambulatory / statistics & numerical data
  • Carotid Intima-Media Thickness / statistics & numerical data
  • China / epidemiology
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis
  • Hypertrophy, Left Ventricular / epidemiology*
  • Kidney Function Tests / methods
  • Male
  • Masked Hypertension* / diagnosis
  • Masked Hypertension* / epidemiology
  • Masked Hypertension* / physiopathology
  • Middle Aged
  • Prevalence
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / physiopathology
  • Risk Factors
  • Statistics as Topic
  • White Coat Hypertension / diagnosis
  • White Coat Hypertension / epidemiology
  • White Coat Hypertension / physiopathology