Background: Despite early operation, persistent and late systolic hypertension are common among children and adolescents after surgical repair of aortic coarctation and can contribute to early cardiovascular morbidity.
Methods: Ambulatory blood pressure monitoring was performed for 78 patients (aged 3.6-22.8 years, 41 male) after successful surgical repair of aortic coarctation (median duration of follow-up 6.5 years, range 0.7-20.1 years). Hypertension was defined as mean systolic blood pressure exceeding the 95th percentile for sex and height.
Results: Twenty-three patients (29%) exhibited systolic hypertension during daytime. Hypertensive patients had been older at the time of operation than had normotensive patients (5.4+/-5.0 versus 2.4+/-3.1 years, P<0.01). Prevalence of hypertension was 21% among patients who had undergone surgery during the first year of life and 38% among patients who had been operated upon later. Decline in blood pressure during night was similar for all patients (systolic 11+/-5% and diastolic 19+/-8%). Systolic hypertension during night-time was found in 24% of patients who were normotensive during day. Diastolic hypertension was rare. Follow-up measurements were performed for 41 patients after 2.3+/-1. 3 years, and most normotensive patients remained normotensive during this time.
Conclusions: Ambulatory blood pressure monitoring allows one to estimate nocturnal hypertension in children and adolescents after surgical repair of aortic coarctation which is common also among normotensive patients during daytime.