Copyright © 1998 by the European Society of Cardiology.
Influence of the postoperative period and surgical procedure on ambulatory blood pressure-determination of hypertension load after successful surgical repair of coarctation of the aorta
a Cardiology Unit, Ste-Justine Hospital
b Physical Education Department, McGill University
c Cardio-Thoracic Surgery Unit, Ste-Justine Hospital, Montreal, Quebec, Canada
accepted September 19, 1997
Aims
This study quantified hypertension load using 24-h ambulatory blood pressure monitoring after successful repair of coarctation of the aorta less than (1) or more than 10 years previously (2) and examined the influence of the surgical procedure (anastomosis or subclavian flap).
Methods and Results
Ambulatory blood pressure recordings were obtained using an Accutracker II monitor every 30min during the day and hourly, at night. Day and night systolic and diastolic values were higher in coarctation of the aorta than in controls: (day: systolic blood pressure/diastolic blood pressure: 133/71±6/4 vs 115/66±3/2 night: systolic blood pressure/diastolic blood pressure: 117/61±4/4 vs 107/57±3/2mmHg, P<0·01) and at all times, were higher in coarctation of the aorta (2) than in coarctation of the aorta (1). Clinical daytime systolic hypertension was observed in 20% of recordings from coarctation of the aorta (1) and 49% from coarctation of the aorta (2) while diastolic hypertension was not observed. However, systolic blood pressure and diastolic blood pressure responses to daily activities were significantly higher in coarctation of the aorta than in controls and this was more marked in coarctation of the aorta (2) than in coarctation of the aorta (1). Type of surgery did not affect either hypertension prevalence or blood pressure reactivity.
Conclusions
These observations indicate exaggerated systolic blood pressure and diastolic blood pressure reactivity after repair of coarctation of the aorta, the prevalence of systolic hypertension doubling 10 years after surgery.
Key Words: hypertension • coarctation of the aorta • ambulatory blood pressure
f1 D. Johnson is the recipient of doctoral fellowships from the ‘Formation de Chercheurs et l'Aide à la Recherche’ program of the Quebec Ministry of Education and from the Graduate Faculty of the University of Montreal.
f2 Correspondence: Professor Hélène Perrault, Université Joseph Fourier, Laboratoire Bioenergetique Fondamentale et Appliquée, UFR Biologie – UFR Medecine – UFR STAPS, BP 53X – 38041 Grenoble Cedex 9, France.
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