Abstract
Objective: Arterial stiffness, expressed by carotid-femoral pulse wave velocity (c-f PWV), is recognized as independent predictor for future cardiovascular disease. The aim of this study was to investigate for the first time the impact of masked hypertension (MH) on c-f PWV, in untreated patients. Design and method: PubMed and Cochrane Library were searched systematically to identify studies comparing c-f PWV levels between normotensives, hypertensives, and MH. Meta-analysis was performed to compare the difference c-f PWV levels between these groups. New Castle Ottawa quality assessment scale for case-control studies was used to assess study quality. Results: MH patients had significantly increased c-f PWV values compared to the normotensive groups (d = 0.95, 95% CI: 0.42 to 1.48, P < 0.01). Moreover, the hypertensive population was found to have statistically significant increased values of c-f PWV compared to MH (d = -0.74, 95% CI: -0.96 to - 0.52, P = 0.18). Finally, there was no statistically significant difference between MH and white coat hypertension population (d = 0.06, 95% CI: -1.04 to 1.15, P < 0.001). Conclusions: MH population have statistically significant increased values of c-f PWV compared to the normotensive group. These results demonstrate the severity of MH and the importance of evaluating blood pressure with out-of-office measurements in the untreated population.
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