Background: Arterial hypertension is a common long-term complication in adults with repaired coarctation of the aorta, and associated with the development of left ventricular hypertrophy.
Aims: This study aimed to investigate the prevalence of elevated (≥ 140/90 mmHg) blood pressure among patients with diagnosed hypertension, and analyse associated factors.
Methods: In the national register for congenital heart disease, 243 adults with repaired coarctation of the aorta, and diagnosed hypertension were identified (27.2 % female, mean age 45.4 ± 15.3 years). Of these, 127 (52.3 %) had elevated blood pressure at the last registration.
Results: In a multivariable model, age (years) (OR 1.03, CI 1.01-1.06) was independently associated with elevated blood pressure, and so was systolic arm-leg blood pressure gradient in the ranges (10, 20] mmHg (OR 4.92, CI 1.76-13.79), and > 20 mmHg (OR 9.93, CI 2.99-33.02), in comparison to the reference interval [0, 10] mmHg. Patients with elevated blood pressure had, on average, more types of anti-hypertensive medication classes prescribed (1.9 vs 1.5, p = 0.003).
Conclusions: Elevated blood pressure is common among patients with repaired coarctation of the aorta and diagnosed hypertension, despite what seems to be more intensive treatment. A systolic arm-leg blood pressure gradient is associated with elevated blood pressure, even at low levels that are usually not considered for intervention, and may be an indicator of hypertension that is difficult to treat.