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

Aims This study quantified hypertension load using 24-h ambulatory blo od pressure monitoring after successful repair of coarctation of the a orta less than (1) or more than 10 years previously (2) and examined t he influence of the surgical procedure (anastomosis or subclavian flap ). Methods and Results Ambulatory blood pressure recordings were obtai ned using an Accutracker II monitor every 30 min during the day and ho urly, at night. Day and night systolic and diastolic values were highe r in coarctation of the aorta than in controls: (day: systolic blood p ressure/diastolic blood pressure: 133/71 +/- 6/4 vs 115/66 +/- 3/2 nig ht: systolic blood pressure/diastolic blood pressure: 117/61 +/- 4/4 v s 107/57 +/- 3/2 mmHg, P<0.01) and at all times, were higher in coarct ation of the aorta (2) than in coarctation of the aorta (1). Clinical daytime systolic hypertension was observed in 20% of recordings from c oarctation of the aorta (1) and 49% from coarctation of the aorta (3) while diastolic hypertension was not observed. However, systolic blood pressure and diastolic blood pressure responses to daily activities w ere significantly higher in coarctation of the aorta than in controls and this was more marked in coarctation of the aorta (3) than in coarc tation of the aorta (1). Type of surgery did not affect either hyperte nsion prevalence or blood pressure reactivity. Conclusions These obser vations indicate exaggerated systolic blood pressure and diastolic blo od pressure reactivity after repair of coarctation of the aorta, the p revalence of systolic hypertension doubling 10 years after surgery.