OBJECTIVE: The Ambulatory blood pressure Registry TEleMonitoring of hypertension and cardiovascular rISk project was designed to set up an international registry including clinic blood pressure (CBP) and ambulatory blood pressure (ABP) measurements in patients attending hypertension clinics in all five continents, aiming to assess different daily life hypertension types. METHODS: Cross-sectional ABP, CBP and demographic data, medical history and cardiovascular risk profile were provided from existing databases by hypertension clinics. Hypertension types were evaluated considering CBP (≥140/90 mmHg) and 24-h ABP (≥130/80 mmHg). RESULTS: Overall, 14 143 patients from 27 countries across all five continents were analyzed (Europe 73%, Africa 3%, America 9%, Asia 14% and Australia 2%). Mean age was 57 ± 14 years, men 51%, treated for hypertension 46%, cardiovascular disease 14%, people with diabetes 14%, dyslipidemia 33% and smokers 19%. The prevalence of hypertension was higher by CBP than by ABP monitoring (72 vs. 60%, P < 0.0001). Sustained hypertension (elevated CBP and ABP) was detected in 49% of patients. White-coat hypertension (WCH, elevated CBP with normal ABP) was more common than masked hypertension (elevated ABP with normal CBP) (23 vs. 10%; P < 0.0001). Sustained hypertension was more common in Europe and America and in elderly, men, obese patients with cardiovascular comorbidities. WCH was less common in Australia, America and Africa, and more common in elderly, obese women. Masked hypertension was more common in Asia and in men with diabetes. Smoking was a determinant for sustained hypertension and masked hypertension. CONCLUSION: Our analysis showed an unbalanced distribution of WCH and masked hypertension patterns among different continents, suggesting an interplay of genetic and environmental factors, and likely also different healthcare administrative and practice patterns.

Italian Institute of Telemedicine Varese Italy bSicor Clinical and Research Center Medellín Colombia cDepartment of Internal Medicine Hospital Mutua Terrassa University of Barcelona Barcelona Spain dConnolly Hospital Dublin Ireland eBaker IDI Heart and Diabetes Institute Melbourne Australia fDepartment of Cardiology Danderyd University Hospital Stockholm Sweden gTurku University Hospital Turku Finland hDivision of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi Japan iDepartment of Cardiology Interventional Elektrocardiology and Hypertension Jagiellonian University Medical College Kraków Poland jHypertension in Africa Research Team North West University Potchefstroom South Africa kDepartment of Hypertension and Diabetology Hypertension Unit Medical University of Gdańsk Gdańsk Poland lExperimental Cardiology Tropical Medicine Institute Central University Caracas Venezuela mDepartment of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan nVascular Medicine Department of Medicine University of Padova Padova Italy oDepartment of Physiotherapy pDepartment of Sport Medicine and Rehabilitation Medical Faculty Masaryk University qSt Anne's University Hospital in Brno Brno Czech Republic rInstituto de Investigacion y estudio de Enfermedades Cardiovasculares Facultad de Medicina Universidad del Zulia Maracaibo Venezuela s 3rd University Department of Medicine Hypertension Center Sotiria Hospital Athens Greece tDivisions of Hypertension and Biometrics FuWai Hospital and Cardiovascular Institute Chinese Academy of Medical Sciences Beijing China uDepartment of Cardiovascular Neural and Metabolic Sciences Istituto Auxologico Italiano vDepartment of Medicine and Surgery University of Milano Bicocca Milan Italy

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