title: Hypertension in adult after operation of aortic coarctation.
abstract: OBJECTIVE
  The benefit of coarctation repair on the resolution of systolic hypertension in adults has been questioned.
  
  
  METHODS
  Between March 1997 and July 2009, 65 consecutive adult patients (≥ 16 years) underwent repair of aortic coarctation. There were 40 men (65%) and 25 women (35%) with a mean age of 22.3 ± 4.8 years (range, 16 to 34 years). All patients had critical systolic blood hypertension (SBP ≥ 140 mmHg). SBP ranged from 140 to 205 mmHg, with a mean of 163.5 ± 17.6 mmHg. The mean diastolic BP was 95.1 ± 18.3 mmHg (range, 70 to 120 mmHg). Most patients (41/65, 74%) were on a regimen of at least one antihypertensive drug.
  
  
  RESULTS
  The patients were followed up after coarctation repair for 2 to 144 months (mean, 68 ± 39 months). There was no death. No other major complications occurred. There have been no repeat interventions during follow-up. Four patients were lost to follow-up. Of the 61 patients with preoperative hypertension, 53 (87%) were normotensive (SBP <140 mmHg) at the most recent follow-up visit. The remaining eight patients showed substantial improvement versus the preoperative status. The mean SBP after operation was 122.5 ± 12.4 mmHg. Mean diastolic blood pressure was 79.5 ± 11.6 mmHg. Forty-one (67%) patients were taking no medication at the last follow-up.
  
  
  CONCLUSIONS
  Surgical repair of coarctation of the aorta in adults can lead to regression of systolic hypertension and a decreased requirement for antihypertensive medication.
authors: Department of Clinical Medicine and Cardiovascular Sciences, University of Naples Federico II, Naples, Italy.
authors: G
authors: G
authors: Palma
authors: R
authors: R
authors: Giordano
authors: V
authors: V
authors: Russolillo
authors: S
authors: S
authors: Cioffi
authors: S
authors: S
authors: Palumbo
authors: M
authors: M
authors: Mucerino
authors: V
authors: V
authors: Poli
authors: C
authors: C
authors: Vosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001017:Aortic Coarctation / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents