The association between estimated pulse wave velocity and masked hypertension: results from the Hungarian ambulatory blood pressure monitoring registry.

OBJECTIVE

Arterial stiffening can promote the development of systolic hypertension, affecting the characteristics of arterial blood flow. Estimated pulse wave velocity (ePWV) can provide information regarding the progression of arterial stiffness. The aim of the present study was to explore the utility of ePWV to predict masked hypertension (MH) in untreated patients or masked uncontrolled hypertension (MUCH) in treated patients with optimal, normal or high-normal office blood pressure (oBP).

METHODS

Data of the Hungarian ABPM Registry between September 2020 and November 2023 were used in our analysis. ePWV was calculated based on previously published formulas in different age categories as ≤40, 40-49, 50-59, 60-69 and ≥70 years. Optimal ePWV values to predict MH or MUCH were defined with classification and regression tree analysis.

RESULTS

Out of 38 720 uploaded ABPM curves with clinical data, 7386 participants had optimal, normal or high-normal oBP. MH or MUCH were diagnosed in 981 (56.3%) or 3367 (59.6%) cases, respectively. Optimal ePWV values to predict MH or MUCH in age categories ≤40, 40-49, 50-59, 60-69 and ≥70 years were 6.84, 7.88, 8.24, 9.98 and 11.44 m/s, respectively. For the prediction of MUCH the identified thresholds were significant predictors in all age categories, while for the prediction of MH from the age above 50 years the associations became nonsignificant.

CONCLUSION

Despite normal oBP categories, ePWV can be a marker of MH and MUCH, thus it can help in patient selection for ABPM.