What should you know about masked hypertension?

Masked hypertension means your blood pressure is higher at home or during daily life than it appears to be in a clinic. Because a single clinic reading may miss this pattern, clinicians may suggest home monitoring or a wearable monitor that records readings through the day and night.

Blood pressure changes with activity, stress, sleep, caffeine and medicines. Some people have reassuring readings in a calm consultation but higher readings during work, exercise or other parts of the day. The pattern can go unnoticed unless readings are collected in your usual environment. Untreated high blood pressure can strain blood vessels and organs, including the heart and kidneys. It is associated with conditions such as [Hypertension](/conditions/hypertension/), [Chronic Kidney Disease](/conditions/chronic-kidney-disease/) and [Heart Failure](/conditions/heart-failure/).

Use the monitoring method your clinician recommends and record when you took medicines, exercised or felt unwell. For a home reading, sit quietly with your back supported, keep both feet on the floor and rest your arm at heart level. Do not change prescribed treatment based on one reading. Share the log and any device readings so your clinician can decide whether repeated monitoring, lifestyle changes or medicine is appropriate. Discuss factors that can raise readings, including [Obesity](/conditions/obesity/) and [Obstructive Sleep Apnoea](/conditions/obstructive-sleep-apnoea/).

Arrange a routine appointment if home readings repeatedly seem higher than clinic readings, or if you have headaches, dizziness or concerns about your treatment. Seek urgent help for a very high reading accompanied by chest pain, severe breathlessness, weakness on one side, confusion, trouble speaking or a sudden severe headache. These symptoms can occur with emergencies such as [Stroke](/conditions/stroke/) or [Angina](/conditions/angina/), and should not wait for a monitoring review.

Ask which monitor to use, how often to measure, whether your medicines should be taken at a particular time, and what readings or symptoms should prompt urgent contact. You can also ask whether kidney health or sleep problems need assessment.