Prevalence of masked and white-coat hypertension among individuals with diabetes: insights from web-based home blood pressure monitoring in the Brazilian population

Hypertens Res. 2024 Dec;47(12):3473-3479. doi: 10.1038/s41440-024-01842-0. Epub 2024 Oct 8.

Abstract

The association between diabetes mellitus (DM) and masked hypertension (MH) in ambulatory blood pressure (BP) monitoring is established, but its relationship with home BP monitoring (HBPM) remains uncertain. This web-based database study compared BP phenotypes in individuals using (n = 51,194; 6.05% with DM) and not using (n = 55,320; 0.63% with DM) antihypertensive medications (AH) undergoing HBPM. Multivariable logistic regression analysis revealed similar MH and white-coat hypertension (WCH) prevalence in individuals with or without DM, irrespective of AH use. However, among AH non-users, DM was associated with a higher likelihood of normotension (OR 1.35, 95%CI 1.09-1.66; p = 0.006) and a lower likelihood of sustained hypertension (OR 0.77, 95%CI 0.60-0.99; p = 0.039) compared to individuals without DM. These findings suggest that while DM does not significantly impact MH and WCH in HBPM, it may influence normotension and sustained hypertension rates in AH non-users. Likelihood of diabetes mellitus according to blood pressure phenotypes. AH - antihypertensive medications; CH - controlled hypertension; MH - masked hypertension; MUCH - masked uncontrolled hypertension; NT - normotension; SH - sustained hypertension; SUCH - sustained uncontrolled hypertension; WCH - white-coat hypertension; WUCH - white-coat uncontrolled hypertension.

Keywords: antihypertensive medications; diabetes; home blood pressure; masked hypertension; normotension.

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory*
  • Brazil / epidemiology
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / physiopathology
  • Female
  • Humans
  • Internet
  • Male
  • Masked Hypertension* / epidemiology
  • Masked Hypertension* / physiopathology
  • Middle Aged
  • Prevalence
  • White Coat Hypertension* / epidemiology
  • White Coat Hypertension* / physiopathology

Substances

  • Antihypertensive Agents