What Is Masked Hypertension and Who Is at Risk?
High blood pressure is one of the most common and most treatable risk factors for heart disease. But what happens when your blood pressure appears normal at the doctor’s office yet runs high in everyday life? This condition is called masked hypertension, and it can be dangerous if left untreated.
What is masked hypertension?
Masked hypertension occurs when a person’s blood pressure readings are normal during a medical visit but elevated outside the clinic, such as at home or work. It’s the opposite of white coat hypertension, when readings are high in a medical setting but normal elsewhere.
Because clinic readings appear normal, masked hypertension often goes undiagnosed, which puts patients at risk for long-term health complications, including heart disease, stroke, and kidney problems over time.
What causes masked hypertension?
Several factors can contribute to masked hypertension:
- Stress at work or home
- Lifestyle factors, such as smoking, high sodium intake, or excessive alcohol use
- Poor sleep quality
- Physical inactivity
- Timing of medications that may wear off between readings
Some people feel relaxed during a doctor’s appointment, which can lead to lower-than-usual blood pressure readings, even if their average blood pressure is consistently elevated throughout the day.
Who is at risk?
You may be more likely to have masked hypertension if you:
- Have a family history of high blood pressure
- Are male or over age 40
- Have diabetes, kidney disease, or other chronic conditions
- Are obese or inactive
- Smoke or consume alcohol frequently
- Have high cholesterol
- Experience frequent stress
Even if your blood pressure looks normal in the clinic, these risk factors may prompt your provider to take a closer look.
How is masked hypertension diagnosed?
If you suspect you have masked hypertension, your doctor may recommend home blood pressure monitoring where you take your blood pressure at various intervals throughout the day or ambulatory blood pressure monitoring, where you wear a blood pressure cuff on the upper arm for 24 hours. These tools capture your blood pressure over time to provide a more complete picture than a single reading at the clinic.
Managing masked hypertension
Masked hypertension is manageable. If you’ve recently been diagnosed, your provider may recommend lifestyle changes like improving your diet, increasing physical activity, reducing chronic stress, or adjusting your medications.
At the Oklahoma Heart Hospital, we help patients uncover hidden risk factors like masked hypertension and create personalized care plans that support long-term heart health. If you have concerns about your blood pressure, particularly if you’re experiencing symptoms like frequent headaches, dizziness, or fatigue, talk to your primary care provider or schedule an appointment with a cardiologist today.