Prevalence and determinants of masked hypertension among black nigerians compared with a reference population

Augustine N. Odili, Lutgarde Thijs, Azusa Hara, Fang Fei Wei, John O. Ogedengbe, Maxwell M. Nwegbu, Lucas S. Aparicio, Kei Asayama, Teemu J. Niiranen, José Boggia, Leonella Luzardo, Lotte Jacobs, George S. Stergiou, Jouni K. Johansson, Takayoshi Ohkubo, Antti M. Jula, Yutaka Imai, Eoin O'Brien, Jan A. Staessen

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Hitherto, diagnosis of hypertension in sub-Saharan Africa was largely based on conventional office blood pressure (BP). Data on the prevalence of masked hypertension (MH) in this region is scarce. Among individuals with normal office BP (<140/90 mm Hg), we compared the prevalence and determinants of MH diagnosed with self-monitored home blood pressure (≥135/85 mm Hg) among 293 Nigerians with a reference population consisting of 3615 subjects enrolled in the International Database on Home Blood Pressure in Relation to Cardiovascular Outcomes. In the reference population, the prevalence of MH was 14.6% overall and 11.1% and 39.6% in untreated and treated participants, respectively. Among Nigerians, the prevalence standardized to the sex and age distribution of the reference population was similar with rates of 14.4%, 8.6%, and 34.6%, respectively. The mutually adjusted odds ratios of having MH in Nigerians were 2.34 (95% confidence interval, 1.39-3.94) for a 10-year higher age, 1.92 (1.11-3.31) and 1.70 (1.14-2.53) for 10- or 5-mm Hg increments in systolic or diastolic office BP, and 3.05 (1.08-8.55) for being on antihypertensive therapy. The corresponding estimates in the reference population were similar with odds ratios of 1.80 (1.62-2.01), 1.64 (1.45-1.87), 1.13 (1.05-1.22), and 2.84 (2.21-3.64), respectively. In conclusion, MH is as common in Nigerians as in other populations with older age and higher levels of office BP being major risk factors. A significant proportion of true hypertensive subjects therefore remains undetected based on office BP, which is particularly relevant in sub-Saharan Africa, where hypertension is now a major cause of death.

Original languageEnglish
Pages (from-to)1249-1255
Number of pages7
Issue number6
Publication statusPublished - 2016 Jun 1
Externally publishedYes


  • home blood pressure monitoring
  • masked hypertension
  • special populations

ASJC Scopus subject areas

  • Internal Medicine


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