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Cited by 61Blood Pressure and Hypertension StudiesCongenital Heart Disease StudiesAortic Disease and Treatment Approaches

Usefulness of Exercise-Induced Hypertension as Predictor of Chronic Hypertension in Adults After Operative Therapy for Aortic Isthmic Coarctation in Childhood

Luijendijk, Paul, Bouma, Berto J., Vriend, Joris W.J., Vliegen, Hubert W., Groenink, Maarten, Mulder, Barbara J.M.·2011·The American Journal of Cardiology
DOI 10.1016/j.amjcard.2011.03.063
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Abstract

Chronic hypertension is a major concern in adults who have undergone resection of coarctation of the aorta (CoA) in childhood. In otherwise healthy subjects, exercise-induced hypertension is prognostic for chronic hypertension; however, the prognostic value in patients with CoA remains unknown. The aim of the present study was to evaluate the predictive value of exercise-induced hypertension for chronic hypertension in these patients. In the present prospective follow-up study, 74 patients with CoA (58% men, age 30.9 ± 9.5 years) underwent ambulatory blood pressure (BP) monitoring and exercise testing twice from 2001 to 2009 with a follow-up period of 6.3 ± 0.8 years. Hypertension was defined as a mean systolic BP ≥140 mm Hg and/or mean diastolic BP ≥90 mm Hg or the need for antihypertensive treatment. Exercise-induced hypertension was defined as a mean systolic BP of <140 mm Hg and peak exercise systolic BP of ≥200 mm Hg. At baseline, 27 patients (36%) were hypertensive, 11 (15%) had exercise-induced hypertension, and 36 (49%) were normotensive. At follow-up, all 27 hypertensive patients remained hypertensive. Of the 11 with exercise-induced hypertension, 7 (64%) had developed chronic hypertension, and 4 (36%) continued to have exercise-induced hypertension. Of the 36 normotensive patients, 7 (19%) had developed hypertension, 12 (33%) had developed exercise-induced hypertension, and 17 (47%) remained normotensive. On multivariate analysis, baseline maximum exercise systolic BP was independently associated with the mean systolic BP at follow-up (β = 0.13, p = 0.005). In conclusion, the maximum exercise systolic BP was a predictor for chronic hypertension in patients with CoA. These findings demonstrate the clinical importance of exercise-induced hypertension and warrant additional study into the long-term consequences of exercise-induced hypertension and the potential beneficial role of early antihypertensive treatment in adult patients after CoA repair with exercise-induced hypertension.

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Authors
Luijendijk, P., Bouma, B. J., Vriend, J. W. J., Vliegen, H. W., Groenink, M., & Mulder, B. J. M.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Haga Hospital (NL)
  • Leiden University Medical Center (NL)
Corresponding author
Mulder, Barbara J.M.
ORCID
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
2011-08
Volume
108
Issue
3
Pages
435-439
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/j.amjcard.2011.03.063
OpenAlex
W2105834083
Cited by
61
References
32
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 1 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 1 · 2014: 6 · 2013: 8 · 2012: 5
FWCI
4.17
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
Keywords
exercise-induced hypertension, chronic hypertension, coarctation of the aorta, exercise testing, ambulatory blood pressure monitoring, hypertension risk prediction, antihypertensive therapy
MeSH terms
Adult, Anastomosis, Surgical, Aorta, Thoracic, Aortic Coarctation, Aortic Valve, Aortic Valve Stenosis, Chronic Disease, Echocardiography, Exercise Test, Female, Follow-Up Studies, Humans, Hypertension, Male, Netherlands, Postoperative Complications, Predictive Value of Tests, Prospective Studies, Recurrence, Registries, Reoperation, Multivariate Analysis, Hypertrophy, Left Ventricular, Blood Pressure Monitoring, Ambulatory, Young Adult

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