Abstract

Objective: The aim of this study was to investigate the reproducibility of masked hypertension (MH) either with ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM). Design and method: PubMed, Cochrane Library and Web of Science were searched to identify studies with paired baseline office BP and ABPM or HBPM measurements at two timepoints. The outcome of the analysis was the individual phenotype reproducibility between the baseline and follow-up timepoints. The used effect measure was Cohen’s kappa coefficient. Results: We found 15 studies eligible for the meta-analysis (5729 patients). The reproducibility of MH was better with ABPM, kappa reliability test: 0.41 (95%CI: 0.32 – 0.49), than with HBPM, kappa reliability test: 0.26 (95%CI: 0.10 – 0.40). Conclusions: This systematic review and meta-analysis show a slight to fair reproducibility of MH assessed through HBPM, but better when assessed with ABPM. Considering that poor reproducibility may be a result of office BP measurements, an ABPM/HBPM based strategy should be established for the evaluation and treatment of patients with MH.

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