Superioridad del monitoreo ambulatorio de presión arterial sobre la medición en consultorio para la detección de hipertensión enmascarada: Una revisión integrativa
Palabras clave:
hipertensión enmascarada, monitoreo ambulatorio de presión arterial, hipertensión de bata blanca, riesgo cardiovascular, diagnósticoResumen
Introducción: La hipertensión arterial es un factor de riesgo cardiovascular prevalente, pero su diagnóstico tradicional mediante medición en consultorio presenta baja sensibilidad. La hipertensión enmascarada, caracterizada por presión normal en clínica y elevada en el entorno ambulatorio, conlleva un riesgo similar a la hipertensión sostenida.
Objetivo: Analizar la precisión diagnóstica del monitoreo ambulatorio de presión arterial (MAPA) frente a la medición en consultorio para la detección de hipertensión enmascarada y evaluar su impacto clínico.
Métodos: Se realizó una revisión integrativa bajo el marco de Whittemore y Knafl. Se analizaron estudios observacionales y ensayos clínicos publicados entre 2005 y 2024 en bases de datos biomédicas (PubMed, Scopus), centrados en adultos con discrepancias de presión arterial.
Resultados: La medición en consultorio mostró una sensibilidad limitada (60-70 %) para descartar hipertensión enmascarada, cuya prevalencia osciló entre el 10 % y el 47 % según el riesgo poblacional. El MAPA identificó marcadores fisiopatológicos críticos como la hipertensión nocturna y el patrón non-dipper, asociados a mayor daño de órgano blanco (hipertrofia ventricular izquierda, rigidez arterial).
Conclusiones: El MAPA es el estándar de referencia indispensable para superar la inercia terapéutica en pacientes con fenotipos de riesgo (obesidad, diabetes, enfermedad renal). Su implementación sistemática es costo-efectiva al prevenir eventos cardiovasculares mayores.
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Derechos de autor 2025 Liz Vanessa Vega, Charles Daniel Sosa, Richiar Ramón Peña Rojas, Maísa Mendes Cumerlatto, André Luís de Souza Beloni, Barbara Suelen Lobos Vera, Karen Andrea Sosa Blanco
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
