What is masked hypertension and why is it important to detect?

• A. Normal clinic BP but elevated home or ambulatory BP; cardiovascular risk is similar to sustained hypertension
• B. Elevated clinic BP but normal home BP; lower risk than sustained hypertension
• C. Elevated home BP only during exercise; no cardiovascular risk
• D. Low clinic BP but high heart rate; increased risk only during activity

Answer: (A)

Masked hypertension means blood pressure looks normal in the clinic but is elevated when measured outside the clinic, such as at home or with ambulatory monitoring. This pattern is important because the cardiovascular risk in masked hypertension is similar to that of sustained hypertension, so patients can have target-organ damage or future events even though office readings seem fine. Detecting it requires taking blood pressure outside the clinic—using home measurements taken on several days (morning and evening) or wearing an ambulatory monitor—to uncover those higher values. This is why relying only on office measurements can miss real hypertension and lead to undertreatment. It’s different from white coat hypertension, where clinic readings are high but home readings are normal.