Hypertension in thoracic transplant recipients

There are many mechanisms underlying the hypertension which occurs after th oracic transplantation. Previous disease, effects of cyclosporin, tacrolimu s and steroid immunosuppression and cardiac denervation are major contribut ory factors, Abnormal sodium and water balance is an important common media ting faster. A new approach is clearly needed for classifying the severity of hypertension in these patients taking into account day-night variation a nd total blood pressure (BP) load: This would allow improved strategies for investigation and treatment. The evidence suggests that ambulatory BP meas urements should be included in the assessment of initial severity of pose-t ransplant hypertension as well as response to treatment, Further studies ar e needed to look at the effects of raised clinic and 24-h ambulatory BP and its treatment on longer term morbidity and mortality in thoracic transplan t patients.