Hypertension in adults with repaired coarctation of the aorta

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• 作者：Daniel Rinnströ ; m ; MD^a ; ^{dan_r_82@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mikael Dellborg ; MD ; PhD^b ; Ulf Thil&eacute ; n ; MD ; PhD^c ; Peder Sö ; rensson ; MD ; PhD^d ; Niels-Erik Nielsen ; MD ; PhD^e ; Christina Christersson ; MD ; PhD^f ; Bengt Johansson ; MD ; PhD^a
• 刊名：American Heart Journal
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：181
• 期：Complete
• 页码：10-15
• 全文大小：169 K

文摘

In adults with coarctation of the aorta (CoA), hypertension (HTN) is a common long-term complication. We investigated the prevalence of HTN and analyzed factors associated with HTN.

Methods and results

In the national register for congenital heart disease, 653 adults with repaired CoA were identified (mean age 36.9 ± 14.4 years); 344 (52.7%) of them had HTN, defined as either an existing diagnosis or blood pressure (BP) ≥140/90 mmHg at the clinical visit. In a multivariable model, age (years) (odds ratio [OR] 1.07, CI 1.05-1.10), sex (male) (OR 3.35, CI 1.98-5.68), and body mass index (kilograms per square meter) (OR 1.09, CI 1.03-1.16) were independently associated with having HTN, and so was systolic arm-leg BP gradient where an association with HTN was found at the ranges of (10, 20] and >20 mmHg, in comparison to the interval ≤10 mmHg (OR 3.58, CI 1.70-7.55, and OR 11.38, CI 4.03-32.11). This model remained valid when all patients who had increased BP (≥140/90 mmHg) without having been diagnosed with HTN were excluded from the analyses.

Conclusions

Hypertension is common in patients with previously repaired CoA and is associated with increasing age, male sex, and elevated body mass index. There is also an association with arm-leg BP gradient, starting at relatively low levels that are usually not considered for intervention.