Abstract
BACKGROUND
Patients with type 2 diabetes mellitus (T2DM) are at an increased risk of masked hypertension (normal office blood pressure with increased out-of-office readings) and its cardiovascular complications. However, data from Africa remain scarce.
OBJECTIVES
To describe the occurrence of masked hypertension and its associated factors among Black patients with T2DM.
METHODS
Patients with T2DM diagnosed for at least 1 year, with office SBP less than 140 mmHg and DBP less than 90 mmHg and not under antihypertensive treatment were consecutively selected from primary healthcare and outpatient clinics, in Maputo and Matola cities in Mozambique. All participants underwent both office and 24-h ambulatory blood pressure (ABPM) measurements. Aortic stiffness was assessed using pulse wave velocity (PWV).
RESULTS
The prevalence of 24-h masked hypertension (95% confidence interval) was 53% (42.8-63.1), being 50% (39.8-60.2) for daytime and 63% (52.8-72.4) for nighttime masked hypertension. The prevalence reached 73% among those with an office SBP greater than 130 mmHg [age-adjusted odds ratio (OR) vs.  12 m/s (age-adjusted OR vs. <10 m/s = 6.90, P = 0.003).
CONCLUSION
Over half of Black patients with T2DM and normal office blood pressure had masked hypertension, which was significantly associated with high office SBP values and increased arterial stiffness. These findings highlight the elevated risk of masked hypertension among Black patients with T2DM and the importance of identifying high-risk individuals for ABPM, particularly in resource-limited settings.