title: Long-term results (up to 18 years) of balloon angioplasty on systemic hypertension in adolescent and adult patients with coarctation of the aorta.
abstract: BACKGROUND
  Little is known regarding the long-term follow-up results of balloon angioplasty (BA) for patients with aortic coarctation (AC) on systemic hypertension.
  
  
  OBJECTIVE
  To define the long-term effect of BA of AC on systemic hypertension in adolescent and adult patients.
  
  
  METHODS
  Follow-up data of 53 patients (36 male), mean age 24 +/- 9 years, undergoing BA for discrete AC at median interval of 11.8 years (range, 4-18 years), including cardiac catheterization, magnetic resonance imaging (MRI), and echocardiography. Patients were divided into two groups at 1 year after BA on the basis of absence (group A: 40 patients) or presence (group B: 11 patients) of persistent hypertension and need for medication.
  
  
  RESULTS
  Fifty-one patients had baseline hypertension, BA produced an immediate reduction in peak AC gradient from 66 +/- 23 mmHg to 10.8 +/- 7 mmHg (p < 0.0001). The immediate systolic blood pressure (SBP) decreased from 165 +/- 17 mmHg (95% CI: 159 to 171) to 125 +/- 10 mmHg (95% CI: 122 to 131) (p < 0.001) in 40 patients (group A) and from 184 +/- 19 mmHg (95% CI: 169 to 198) to 142 +/- 22 mmHg (95% CI: 124 to 156) (p<0.001) in 11 patients (group B). At 1-year follow-up, SBP decreased further to 115 +/- 10 in group A (95% CI 111-119) and 134 +/- 19 in group B (95% CI 122-142) (p<0.001). The blood pressure had normalized without medication in group A (165 +/- 17 to 115 +/- 10 mmHg).
  
  
  CONCLUSIONS
  Long-term results of BA for discrete AC are excellent and should be considered as the first option for treatment of this disease. No paradoxical hypertension occurred post angioplasty, and normalization of blood pressure without medication occurred in 78% of the patients after BA.
authors.affiliation: King Faisal Heart Institute and Department of Pharmacy, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. hassanw@kfshrc.edu.sa
authors.forename: Walid
authors.initials: W
authors.lastname: Hassan
authors.forename: Shahid
authors.initials: S
authors.lastname: Malik
authors.forename: Nathem
authors.initials: N
authors.lastname: Akhras
authors.forename: Mohamed Al
authors.initials: MA
authors.lastname: Amri
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shoukri
authors.forename: Mohamed Eid
authors.initials: ME
authors.lastname: Fawzy
mesh_terms: D000293:Adolescent; D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome