Fate of hypertension after repair of coarctation of the aorta in adults.
BACKGROUND
Unrepaired aortic coarctation is known to have a detrimental effect on survival. The benefit of coarctation repair on systolic hypertension in adults has been questioned. This retrospective study was conducted to evaluate the impact of repair of aortic coarctation on systolic hypertension in adults.


METHODS
Repair of aortic coarctation was performed in 84 patients aged 16-54 (mean 29) years. All patients were hypertensive before surgical intervention (mean systolic blood pressure 162 mmHg; mean diastolic blood pressure 93 mmHg). All patients underwent echocardiography and/or cardiac catheterization. The peak mean systolic gradient across the coarctation was 60 mmHg. The patients were followed after coarctation repair for between 1 and 12 (mean 5.2) years.


RESULTS
There was significant regression of hypertension (P < 0.001) in all patients. Thirty-five patients (42 per cent) did not need any antihypertensive medication 3 months after surgery. The prevalence of hypertension at the last follow-up (after mean 5.2 years) was 31 per cent.


CONCLUSIONS
Surgical repair of coarctation of the aorta in adults leads to regression of systolic hypertension and a decreased requirement for antihypertensive medication.
Bhat
M A
MA
Department of Cardiovascular and Thoracic Surgery, Sri Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvanthapuram, India. root@skims.ren.nic.in
Neelakandhan
K S
KS
Unnikrishnan
M
M
Rathore
R S
RS
Mohan Singh
M P
MP
Lone
G N
GN
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001017:Aortic Coarctation / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome