Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement: The Ohasama study

Azusa Hara, Takayoshi Ohkubo, Takeo Kondo, Masahiro Kikuya, Yoko Aono, Sugiko Hanawa, Kyoko Shioda, Sayaka Miyamoto, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Kei Asayama, Takuo Hirose, Kazuhito Totsune, Haruhisa Hoshi, Shin Ichi Izumi, Hiroshi Satoh, Yutaka Imai

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20 Citations (Scopus)


Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85mmHg, CBP <140/90mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP ≥140/90 mmHg; MHT, HBP ≥135/85mmHg, CBP <140/90 mmHg; sustained hypertension, HBP≥135/85 mmHg, CBP ≥140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.

Original languageEnglish
Pages (from-to)1049-1055
Number of pages7
JournalJournal of hypertension
Issue number5
Publication statusPublished - 2009 May
Externally publishedYes


  • General population
  • Home blood pressure
  • Masked hypertension
  • Silent cerebrovascular lesions
  • White-coat hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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