Insufficient control of out-of-office blood pressure: the problem of masked uncontrolled hypertension

Abstract

Despite significant advances in the diagnosis and treatment of arterial hypertension (AH), the problem of insufficient blood pressure (BP) control in hypertensive patients is quite acute. According to current guidelines, the effectiveness of antihypertensive therapy is mainly assessed by reaching the target levels of office BP, while masked uncontrolled hypertension (MUCH), which is diagnosed on the basis of insufficient control of out-of-office BP, increases the risk of cardiovascular events. Patients with insufficient out-of-office BP control have an increased risk of cardiovascular events compared to patients with both office and out-of-office BP control, therefore MUCH requires timely diagnosis and correction. This minireview summarizes the understanding of the nature of MUCH. A particular attention is paid to risk factors and ways of influencing the out-of-office BP control. The article also assessed the important contribution of ABPM to the control of out-of-office BP and to determining the overall risk of MUCH.