A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation

Exercise hypertension is a common occurrence among individuals with aortic coarctation. Although exercise is known to be beneficial among the general population, the risks and benefits of exercise among those with aortic coarctation are less clear. This systematic review evaluates the benefits and risks of exercise for persons with aortic coarctation. Electronic databases were systematically searched (that is, MEDLINE and EMBASE) and key reviews cross-referenced to identify articles for inclusion. Original research articles reporting exercise among individuals with aortic coarctation were included. From 2608 individual citations, 68 eligible articles were identified. Aerobic exercise stress tests were found to be useful for determining exercise hypertension experiences post-surgical repair (N=5), and other long-term secondary findings (N=3). Experiences of exercise hypertension were associated with abnormal cardiac and/or aortic geometry and cardiac function (N=7). Exercise capacity was generally found to be similar to non-aortic coarctation controls post surgery (N=6). Exercise hypertension was experienced by 27% of participants, including 10% of adults and 43% of children/youth. Individuals who experience exercise hypertension experience greater increases in systolic blood pressure with exercise. No investigations identified evaluated forms of exercise other than aerobic stress tests and no exercise training programs have been conducted to date. Exercise stress tests can be valuable in this population for determining exercise hypertension, especially in the year post-surgical repair. Additional research is urgently needed to accurately assess the benefits and risks of exercise and exercise hypertension, and applicability of exercise restrictions for this population.