MASKED HYPERTENSION IN A VERY HIGH CARDIOVASCULAR RISK PATIENT: A CASE REPORT WITH REVIEW OF LITERATURE

Masked hypertension is considered as one of the most important and difficult to diagnose issues of modern cardiology. Its occurrence frequency still remains a mystery. Masked hypertension cannot be diagnosed by routine medical examinations and carries an adverse prognosis, both in terms of increased target organ damage and cardiovascular events. We report a case of a 68 years old Caucasian female with a masked hypertension and lumbar hernia, who was referred to our hospital for further management in May, 2014. Patient?s past medical history was remarkable for generalized atherosclerosis and 7-year history of type 2 diabetes mellitus. In March 2013 she was diagnosed with STEMI and was undergone to the CABG surgery. In 6 months from the CABG surgery patient underwent to the endovascular treatment of Leriche\'s syndrome and one aortic and two iliac stents were placed. Patient was considered as a normotensive through years according to the multiple office blood pressure measurements; hence, she was not on an antihypertensive treatment. Very high cardiovascular risk profile played a crucial role for us to suspect about existence of masked uncontrolled hypertension and 24 hour blood pressure monitoring was performed. Diagnosis of hypertension was confirmed. Arterial hypertension is considered as a leading risk-factor for cardiovascular morbidity and mortality and is associated with the increased level of global mortality; hence, to reveal existence of masked hypertension, to start adequate and early treatment and reach diurnal as well as long-term control is crucial to avoid future severe and life-threatening complications.