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Masked hypertension is reported to have the same level of hazard risk of cardiovascular mortality and stroke morbidity as sustained hypertension. The number of managerial employees suffering from cardiovascular disease and stroke is known to be greater than other employee. The aim of this study was to compare the 24-h blood pressure (BP) recordings between elderly male managerial employees and retirees and to propose a strategy for identifying masked hypertension. A total of 38 males (16 managerial employees aged 50-69 years and 22 retirees aged 60-65 years) who were not taking any antihypertensive medications participated in this study. Their 24-h BP was measured by an ambulatory BP monitoring device. Daytime (9:00-17:00 h) BPs of the employees (mean, 139/92 mm Hg) were significantly higher than in the retirees (mean 124/80 mm Hg), while there was no difference in BP before and during sleep. In all, 5 of 16 employees (31%) who were diagnosed as normotensive (<140/90 mm Hg) at a periodic health check had hypertension (>135/85 mm Hg) in the morning measured by ambulatory BP monitoring, while 6 (38%) had a similar level of hypertension during the daytime (9:00-17:00h). These individuals were diagnosed as having masked hypertension. Multiple regression analyses showed that the job was the only factor that contributed to the difference in BP in the subjects during the daytime. This finding suggested that job stress seemed to be one of the main causes of masked hypertension. We argue that more frequent measurements of BP at the work place are necessary to identify subjects with masked hypertension. [ABSTRACT FROM AUTHOR]

Recent reports suggest that high blood pressure (BP) during the night is associated with hypertensive organ damage, and that increased BP in the morning is closely related to the incidence of stroke and ischemic heart disease. The aim of this study was to investigate the relationships between overnight urinary indicators and 24-hour (24-h) BP, especially in the morning and during sleep in the elderly. A total of 85 volunteers (males 43, females 42), aged between 51 and 76 years and not taking any antihypertensive medications, participated in this study. Their 24-h BP was measured by ambulatory BP monitoring every 30-minute using a TERUMO ES-H531 system. Overnight urine samples were collected using a proportional urine-sampling device, Urine mate P. Overnight sodium (UNan) and potassium (UKn) excretions were measured by an ion electrode method. Simple linear regression analyses showed that systolic blood pressure (SBP) in the morning and diastolic blood pressure (DBP) during sleep were negatively related with overnight urinary weight standardized for body weight (UWn/BW). Multiple regression analyses showed that SBP during the morning and during sleep was positively related to UNan and negatively related to UWn/BW. We also found a negative relationship between SBP during sleep and UKn. The study suggested that urine weight adjusted for BW was negatively related with 24-h BP, especially morning BP. Sodium excretion combined with a large volume of urine proportional to body weight may prevent increases in BP, especially in the morning. [ABSTRACT FROM AUTHOR]