TY - JOUR
T1 - Pressor response to 30-s breathhold
T2 - A predictor of masked hypertension
AU - Lyamina, Nadezhda P.
AU - Smith, Michael L.
AU - Lyamina, Svetlana V.
AU - Manukhina, Eugenia B.
AU - Senchikhin, Valery N.
AU - Pacchia, Christina F.
AU - Downey, H. Fred
N1 - Funding Information:
This research was funded by the Saratov Institute of Cardiology, Saratov, Russian Federation.
PY - 2012/12
Y1 - 2012/12
N2 - One in six adults has normal arterial blood pressure (BP) during a routine examination, but is hypertensive in other environments. This masked hypertension (MHT) may delay treatment until target organ damage has occurred. A sensitive, specific and economical test is needed to detect or exclude MHT in apparently normal subjects. The BP response to a 30-s breathhold (BH test) was observed in 269 young subjects with no evidence of cardiovascular disease. Of 226 normotensives (office BP ≤ 120/80), 25 (11%) had a positive BH test (test BP > 140/90 mmHg), and 12 (44%) of these subjects had MHT (positive 24-h ambulatory BP monitoring (BPM)). Of 201 subjects with negative BH test, none had MHT (negative BPM). Of 43 subjects with high normal BP (office BP > 120/80 < 140/90), 28 (65%) had a positive BH test and 22 of these subjects had MHT (positive BPM). Of the 15 subjects with high normal BP and with a negative BH test, none had MHT (negative BPM). Overall, the BH pressor test and BPM agreed in 93% of cases, and the BH test produced no false negative findings. The BH pressor test effectively ruled out MHT in normal subjects and accurately identified a population that should be further evaluated for MHT.
AB - One in six adults has normal arterial blood pressure (BP) during a routine examination, but is hypertensive in other environments. This masked hypertension (MHT) may delay treatment until target organ damage has occurred. A sensitive, specific and economical test is needed to detect or exclude MHT in apparently normal subjects. The BP response to a 30-s breathhold (BH test) was observed in 269 young subjects with no evidence of cardiovascular disease. Of 226 normotensives (office BP ≤ 120/80), 25 (11%) had a positive BH test (test BP > 140/90 mmHg), and 12 (44%) of these subjects had MHT (positive 24-h ambulatory BP monitoring (BPM)). Of 201 subjects with negative BH test, none had MHT (negative BPM). Of 43 subjects with high normal BP (office BP > 120/80 < 140/90), 28 (65%) had a positive BH test and 22 of these subjects had MHT (positive BPM). Of the 15 subjects with high normal BP and with a negative BH test, none had MHT (negative BPM). Overall, the BH pressor test and BPM agreed in 93% of cases, and the BH test produced no false negative findings. The BH pressor test effectively ruled out MHT in normal subjects and accurately identified a population that should be further evaluated for MHT.
KW - Apnea
KW - Breathhold test
KW - Chemoreflex
KW - Early detection screening
KW - Masked arterial hypertension
UR - http://www.scopus.com/inward/record.url?scp=84870681342&partnerID=8YFLogxK
U2 - 10.3109/08037051.2012.694213
DO - 10.3109/08037051.2012.694213
M3 - Article
C2 - 22725829
AN - SCOPUS:84870681342
SN - 0803-7051
VL - 21
SP - 372
EP - 376
JO - Blood Pressure
JF - Blood Pressure
IS - 6
ER -