Masked hypertension is characterized by

• A. Elevated readings at home, low in the office
• B. Elevated readings in the office only
• C. Normal readings in both settings
• D. Elevated readings at night

Answer: (A)

Masked hypertension occurs when blood pressure readings are normal in the clinic but elevated outside, especially at home or during daily activities. This pattern is tricky because it hides hypertension if we rely only on office measurements, yet it carries cardiovascular risk similar to sustained hypertension. The best description is elevated readings at home with a low or normal office reading, which is why home or ambulatory BP monitoring is used to confirm the diagnosis and guide treatment. In contrast, elevated readings in the office only describe white coat hypertension, normal readings in both settings describe normotension, and elevated readings at night describe nocturnal hypertension, a different pattern.