A 50-year-old man has a clinic blood pressure of 128/82 mmHg on three occasions. His average daytime ambulatory blood pressure is 146/94 mmHg. There is no evidence of target organ damage. This pattern is best described as:
- A White coat hypertension
- B Masked hypertension ✓
- C Resistant hypertension
- D Sustained hypertension
Correct answer: B. Masked hypertension
Explanation
Masked hypertension is defined as a normal office blood pressure with elevated out-of-office readings. White coat hypertension is the opposite: elevated office readings with normal out-of-office values. Sustained hypertension is elevated in both settings. Resistant hypertension requires uncontrolled blood pressure on three drugs including a diuretic. Ambulatory monitoring is essential to identify masked hypertension.
Reference: Harrison's Principles of Internal Medicine, 20th ed.
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