Epidemiological Impact and Clinical Consequences of Masked Hypertension: A Narrative Review

Vincenzo Cesario, Vivianne Presta, Ilaria Figliuzzi, Barbara Citoni, Allegra Battistoni, Francesca Miceli, Massimo Volpe, Giuliano Tocci

Research output: Contribution to journalReview articlepeer-review


Masked hypertension (MHT) is a clinical condition characterized by normal blood pressure (BP) levels during clinical consultation and above normal out-of-office BP values. MHT is associated to an increased risk of developing hypertension-mediated organ damage (HMOD) and major cardiovascular (CV) outcomes, such as myocardial infarction, stroke, and hospitalizations due to CV causes, as well as to metabolic abnormalities and diabetes, thus further promoting the development and progression of atherosclerotic disease. Previous studies showed contrasting data on prevalence and clinical impact of MHT, due to not uniform diagnostic criteria (including either home or 24-h ambulatory BP measurements, or both) and background antihypertensive treatment. Whatever the case, over the last few years the widespread diffusion of validated devices for home BP monitoring has promoted a better diagnostic assessment and proper identification of individuals with MHT in a setting of clinical practice, thus resulting in increased prevalence of this clinical condition with potential clinical and socio-economic consequences. Several other items, in fact, remain unclear and debated, particularly regarding the therapeutic approach to MHT. The aim of this narrative review is to illustrate the clinical definition of MHT, to analyze the diagnostic algorithm, and to discuss the potential pharmacological approaches to be adopted in this clinical condition, in the light of the recommendations of the recent European hypertension guidelines.

Original languageEnglish
Pages (from-to)195-201
Number of pages7
JournalHigh Blood Pressure and Cardiovascular Prevention
Issue number3
Publication statusPublished - Jun 2020


  • Antihypertensive Agents/therapeutic use
  • Blood Pressure/drug effects
  • Blood Pressure Determination
  • Humans
  • Masked Hypertension/diagnosis
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior


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