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Is the burden of late hypertension and cardiovascular target organ damage in children and adolescents with coarctation of the aorta after early successful repair different to healthy controls?

Published online by Cambridge University Press:  22 July 2020

Ayşe Ağbaş Open the ORCID record for Ayşe Ağbaş [Opens in a new window] ,
Selman Gökalp Open the ORCID record for Selman Gökalp [Opens in a new window] ,
Nur Canpolat ,
Salim Çalışkan  and
Funda Öztunç
Ayşe Ağbaş*
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Selman Gökalp
Affiliation:
Department of Pediatric Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Nur Canpolat
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Salim Çalışkan
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Funda Öztunç
Affiliation:
Department of Pediatric Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
*
Author for correspondence: A. Ağbaş, MD, Istanbul University-Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey. Tel: +905053171245; Fax: +902126328633. E-mail: yurtayse@hotmail.com
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Abstract

Objective:

Cardiovascular morbidity is high in patients with coarctation of aorta even after successful repair. This study aimed to assess the frequency of late hypertension and the relationship between ambulatory hypertension and cardiovascular target organ damage in children and adolescents after early and successful repair of coarctation of the aorta.

Methods:

Twenty-five children and adolescents (mean age 13.5 ± 3.43 years) with repaired coarctation of the aorta (median age at repair 4 months, arm–leg gradient <20 mmHg) and 16 healthy controls were included. Office and ambulatory blood pressure, pulse wave velocity, and left ventricular mass index were assessed.

Results:

Both day- and night-time systolic blood pressure standard deviation score and left ventricular mass index were significantly higher in patients compared to controls (p ≤ 0.001 for all), whereas pulse wave velocity did not differ. The prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy were 40, 28, and 24%, respectively. Left ventricular mass index was higher in patients with sustained hypertension, masked hypertension, and normotension compared to controls (p < 0.05). In multivariate analysis, higher night-time systolic blood pressure standard deviation score was the only independent predictor of left ventricular mass index.

Conclusion:

The present study reveals a high prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy in children and adolescents with coarctation of the aorta even after early and successful repair. Ambulatory blood pressure monitoring should be considered to diagnose hypertension. All coarctation of aorta patients should be followed up lifelong and encouraged to establish a healthy lifestyle starting from childhood.

Keywords

Coarctation of aortahypertensiontarget organ damageleft ventricular hypertrophyambulatory blood pressure monitoring
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1305 - 1312
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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