PP.24.03

Abstract

Objective: To determine the detectability, clinic features and prognosis of masked hypertension (MHT) in midlife working women. Design and method: We evaluated 784 midlife women (30–58 y.o.), employees of industrial institutions without specified occupational hazards. Patients with clinical signs of cardiovascular diseases, pregnant, using peroral contraception were excluded. All subjects were performed “office” blood pressure (BP) measurement. MHT was diagnosed by 30-s breathhold test (BH test). Sitting BP was measured initially and remeasured after 30 seconds of breath holding. BH test was considered positive when BP increased > 140/90 mm Hg. Clinical and laboratory screening included fasting plasma glucose, creatinine, uric acid, lipid profile. Screening of anxious (A) and depressive (D) disorders and quality of life self-rating (QLSR) analysis with five-point grading scale were performed. Results: In 71.9% of screened women normal BP was detected, in 19.6% - manifest hypertension, in 8.5% - MHT. During screening “office” BP measurement the maximum sensitivity (84%) was obtained by mean hemodynamic pressure (MHP) measurement. The frequency of dyslipidemia detection was significantly higher in manifest hypertension and MHT patients as compared to normotensive ones (p < 0.05). In MHT women increasing of fasting plasma glucose, decreasing of glomerular filtration rate and other biochemical values were not significantly changed. The level of A and D disorders in normotensive (7.6 and 5.6) was higher than in MHT (5.4 and 4.0) and manifest hypertension (7.9 and 5.0) (A: Kruskal-Wallis p = 0.138; D: Kruskal-Wallis p = 0.342). QLSR level was not significantly different between the groups: Kruskal-Wallis p = 0.618. Risk of fatal cardiovascular events (CVE) in women with MHT was significantly higher than in normotensive and comparable with manifest hypertension women (0.68, 0.45 and 0.76%, respectively). Conclusions: MHT state in midlife working women is characterized by the high sensitivity of MHP measurement, increased frequency of dyslipidemia, tendency to fasting plasma glucose increasing, decreased glomerular filtration rate, the absence of association between MHT and elevated levels of anxious and depressive disorders. 10-years risk of fatal CVE events in midlife working women with MHT is significantly higher vs. normotensive subjects and comparable with manifest hypertension women.