Nihon rinsho. Japanese journal of clinical medicine
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Patients with masked hypertension show normal office blood pressure but elevated out-of-office blood pressure. Out-of-office blood pressure is evaluated by ABPM (ambulatory blood pressure monitoring) or HBPM (home blood pressure measurements). HBPM is more popular in Japan because its simplicity. ⋯ Patients with masked hypertension have increased cardiovascular morbidity risk as high as seen in those with established hypertension. Many factors, including life style (smoking, excessive alcohol drinking, etc), variability of blood pressure (morning surge, non-dipper, riser) and inappropriate treatment of hypertension, are involved in masked hypertension. Life style modification, strict and sophisticated blood pressure control, and treatment of underlying diseases are necessary to treat masked hypertension.
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Early morning hypertension and morning blood pressure surge have been reported to be associated with organ damage and cardiovascular events. The concept of early morning hypertension and morning blood pressure surge is sometimes discussed in the same arena, and provides partly overlapping information concerning their mechanism or risk profile. ⋯ First, early morning hypertension is blood pressure level, while morning blood pressure surge is variability of blood pressure. Second, the intervention of early morning hypertension is available, which lead to prevent the progression of organ damage or cardiovascular event, but there is not enough evidence whether the reduction of morning blood pressure surge would reduce cardiovascular outcome.