Factors tied to masked hypertension vary depending on sleep hypertension

The presence of sleep hypertension modifies the sleep-related factors associated with masked hypertension, according to a study.

“Masked hypertension, which is characterized by out-of-office hypertension but normal office blood pressure, is a risk factor for cardiovascular disease,” the authors said. “However, the factors that contribute to masked hypertension are unclear.”

To address this limitation, 3,844 normotensive (systolic/diastolic blood pressure <140/90 mm Hg) community residents with no antihypertensive drug use at baseline (mean age 54.3 years) were assessed in this study.

The authors measured home morning and evening blood pressure, oxygen desaturation during sleep (pulse oximetry), and sleep efficiency (actigraphy) for 1 week. They also obtained the number of nocturnal urinations during this period using a sleep diary.

Of the participants, 11.7 percent had masked hypertension (mean morning and evening blood pressure ≥135/85 mm Hg), and among those with masked hypertension 79.0 percent had sleep hypertension (≥120/70 mm Hg).

On multinominal logistic regression analysis, the authors identified several factors involved in masked hypertension with and without sleep hypertension.

Factors related to masked hypertension with sleep hypertension were the frequency of at least 3-percent oxygen desaturation (coefficient, 0.038; p=0.001), nocturia (coefficient, 0.607; p<0.001), and carotid intima-media thickness (coefficient, 3.592; p<0.001). For masked hypertension without sleep hypertension, the only factors included were carotid intima-media thickness and measurement season.

Notably, low sleep efficiency correlated with isolated sleep hypertension but not masked hypertension.

“Sleep-disordered breathing and nocturnal urination frequency may help identify individuals who need home blood pressure monitoring,” the authors said.