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Masked hypertension in young patients after successful aortic coarctation repair: impact on left ventricular geometry

G Di Salvo1, B Castaldi, L Baldini

  • 1Second University of Naples, Monaldi Hospital, Chair of Cardiology, Pediatric Cardiology, GUCH Unit, Naples, Italy. giodisal@yahoo.it

Journal of Human Hypertension
|January 14, 2011
PubMed

Insights

Masked hypertension (MH) is common in young aortic coarctation (AoC) patients after repair. This condition, undetected by standard BP checks, impacts heart structure and function, necessitating ambulatory monitoring.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Hypertension Research

Background:

  • Aortic coarctation (AoC) repair improves life expectancy but late hypertension and atherosclerosis remain concerns.
  • Masked hypertension (MH) presents normal office blood pressure (BP) with elevated ambulatory BP, posing a risk.
  • Assessing MH prevalence and its cardiovascular impact in young AoC patients is crucial for long-term management.

Purpose of the Study:

  • To determine the prevalence of masked hypertension (MH) in young, successfully repaired aortic coarctation (AoC) patients.
  • To evaluate the association between MH and left ventricular (LV) geometry and function in these patients.
  • To highlight the clinical significance of ambulatory BP monitoring in AoC follow-up.

Main Methods:

  • Seventy-six young AoC patients (mean age 14.5 years) underwent 24-hour ambulatory BP monitoring (ABPM).
  • Patients were categorized into real normotensive (RN) and masked hypertensive (MH) groups based on ABPM results.
  • Left ventricular (LV) mass, geometry, and deformation properties were assessed and compared between groups.

Main Results:

  • MH was prevalent in 36 of 76 AoC patients (47%).
  • MH patients exhibited increased aortic arch pressure gradients and elevated LV mass compared to RN patients.
  • Reduced regional longitudinal deformation and LV twist were observed in the MH group, indicating impaired cardiac function.

Conclusions:

  • Masked hypertension is common in young patients with repaired aortic coarctation and is linked to adverse LV structural and functional changes.
  • Standard BP measurements may underestimate hypertension risk in AoC survivors.
  • Routine 24-hour ambulatory BP monitoring is recommended for early detection and management of MH in AoC patients.

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