Repair of coarctation of the aorta in adults and hypertension.

The aim of this study is to determine if surgical repair of coarctation in adults improves systemic hypertension. The charts of 23 consecutive patients (age range 13-36 years, mean 23.6+/-7) who underwent repair of aortic coarctation at the Atatürk University, Aziziye Hospital, between 1986 and 2000 were reviewed. There were 16 (70%) men and seven (30%) women. All patients had preoperative hypertension. Systolic blood pressure (BP) ranged between 150 and 200 mmHg, with a mean of 176+/-15 mmHg. Peak systolic gradient across the coarctation was 52+/-20 mmHg (range from 30 to 112 mmHg). There were no early or late deaths. Mean systolic BP values at the first postoperative evaluation were 176+/-15 mmHg (p<0.001 from preoperative values). Exercise testing revealed hypertensive response to exercise in three of 10 patients who had borderline hypertension at rest and without medication. Repair of coarctation of aorta even in adults is safe and improves systemic hypertension. To identify patients with potential hypertension, exercise testing should be performed. Impaired arterial dilatation may be an important contributor to exercise-related hypertension and late morbidity or mortality.