Effective use of captopril in postoperative paradoxical hypertension of coarctation of the aorta.

Severe systemic hypertension may complicate the postoperative course of patients undergoing surgical repair for coarctation of the aorta. The sympathetic and the renin-angiotensin systems have been demonstrated as underlying mechanisms for this paradoxical phenomenon (Farrell et al., 1979; Rocchini et al., 1979). We recently utilized captopril, a competitive inhibitor of angiotensin converting enzyme, with success in the management of severe hypertension that developed in a 15-year-old male after successful surgical repair for coarctation of the aorta. To our knowledge, this is the first report on the use of captopril for the treatment of this paradoxical phenomenon.