Left ventricular hypertrophy in isolated and dual masked hypertension

Masked hypertension (MH) is defined as normal office blood pressure (BP) and elevated ambulatory BP (ABP) or home BP or both. This study assessed the association of MH (ie, isolated home, isolated ABP and dual MH) with echocardiographic left ventricular hypertrophy (LVH). The present analysis of the PAMELA study included 1087 untreated and treated participants with normal office BP and a measurable LV mass (LVM). A total of 193 individuals (17.7%) had any MH (ie, normal office BP, elevated ABP or home BP or both), 48 had dual MH (25%), 62 isolated ambulatory MH (32%), and 83 isolated home MH (43%). Average LVM indexed to body surface area was superimposable in the three MH phenotypes (being the largest difference between groups <3 g/m²) and significantly higher than in true normotensives. This was also for the LVH prevalence that varied across the MH subgroups in a narrow range (from 8.3% to 10.8%). In conclusion, individuals from the general population with isolated MH, in which either home or ABP was elevated, exhibited an increased risk of LVH similar to that entailed by dual MH. Our findings add the notion both home and ABP measurements are useful to more accurately assess the risk of LVH associated with MH in the community.