Ambulatory blood pressure in patients with occult recurrent coarctation of the aorta

M. D. Parrish, E. Torres, Ronald M Peshock, David E Fixler

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18 Scopus citations

Abstract

The hypothesis that mild recurrent aortic obstruction produces subtle changes in ambulatory blood pressure was investigated by performing 24-hour monitoring on 11 postoperative coarctation patients. Patients (age 16.1±2.7 years) were compared with normal controls (age 15.7±2.5 years, n=15). Surgery (end-to-end anastomosis) was performed at 6.0±1.0 years of age. There were no significant differences between patients and controls in terms of baseline blood pressure (right arm 123/78±4/3 mmHg versus 120/75±3/2 mmHg) or right leg systolic pressure (125±6 mmHg versus 123±4 mmHg). Of the 11 patients 8 had recoarctation by Doppler study (mean gradient 25.3±2.1 mmHg), 5 of 11 had a postexercise arm-leg pressure difference of>30 mmHg, and 6 patients had aortic diameters at the site of surgery <70% of the descending aortic diameter (by magnetic resonance imaging). There were no significant differences between the coarctation and control groups in terms of mean ambulatory systolic (125±3 mmHg versus 119±2 mmHg) or diastolic (69±2 mmHg versus 72±2 mmHg) pressures throughout the day. However, coarctation patients had a larger number of systolic pressures that exceeded the 95th percentile (18.2±5.6% versus 6.8±1.2%). These labile increases in systolic pressure correlated with residual coarctation (r=0.642, p=0.003). Ambulatory monitoring is a useful tool for detecting and monitoring subtle abnormalities of blood pressure control after coarctation repair.

Original languageEnglish (US)
Pages (from-to)166-171
Number of pages6
JournalPediatric Cardiology
Volume16
Issue number4
DOIs
Publication statusPublished - Jul 1995

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Keywords

  • Ambulatory blood pressures
  • Coarctation
  • Hypertension

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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