title: Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta; association with systolic blood pressure in the high normal range.
abstract: Arterial hypertension is common in adults with repaired coarctation of the aorta (CoA). The associations between the diagnosis of hypertension, actual blood pressure, other factors affecting left ventricular overload, and left ventricular hypertrophy (LVH) are not yet fully explored in this population.
  
  
  
  From the national register for congenital heart disease, 506 adult patients (≥18years old) with previous repair of CoA were identified (37.0% female, mean age 35.7±13.8years, with an average of 26.8±12.4years post repair). Echocardiographic data were available for all patients, and showed LVH in 114 (22.5%) of these. Systolic blood pressure (SBP) (mmHg) (OR 1.02, CI 1.01-1.04), aortic valve disease, (OR 2.17, CI 1.33-3.53), age (years) (OR 1.03, CI 1.01-1.05), diagnosis of arterial hypertension (OR 3.02, CI 1.81-5.02), and sex (female) (OR 0.41, CI 0.24-0.72) were independently associated with LVH. There was an association with LVH at SBP within the upper reference limits [130, 140] mmHg (OR 2.23, CI 1.05-4.73) that further increased for SBP>140mmHg (OR 8.02, CI 3.76-17.12).
  
  
  
  LVH is common post repair of CoA and is associated with SBP even below the currently recommended target level. Lower target levels may therefore become justified in this population.
authors.affiliation: Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rinnström
authors.affiliation: Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Dellborg
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Thilén
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Peder
authors.initials: P
authors.lastname: Sörensson
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Sweden.
authors.forename: Niels-Eric
authors.initials: NE
authors.lastname: Nielsen
authors.affiliation: Department of Clinical Sciences, Uppsala University, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Christersson
authors.affiliation: Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden. Electronic address: bengt.johansson@umu.se.
authors.forename: Bengt
authors.initials: B
authors.lastname: Johansson
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Adult congenital heart disease; CoA; Hypertension; Left ventricular hypertrophy