Blood flow resistance in the hand after coarctectomy

Patients with established hypertension have an increased blood-flow resistance at maximal vasodilatation, which has been interpreted as being caused by a wall thickening in the resistance vessels. Hand blood-flow resistance at maximal vasodilatation was estimated from intra-arterial mean blood pressure and plethysmographically determined hand blood-flow in ten young men, operated upon for coarctation of the aorta during childhood. The patients were compared with different reference groups examined in the same way. The resting mean blood pressure in the coarctation group was only slightly elevated, to the level of a group of patients with mild blood pressure elevation, while the blood-flow resistance at maximal vasodilatation was markedly increased and equalled that found in a group of patients with established hypertension. This discrepancy between blood pressure and blood-flow resistance suggests a limited reversibility of structural changes in the resistance vessels, originating from the preoperative period with high blood pressure, and might be an argument in favour of early operation and/or antihypertensive medication in children with coarctation of the aorta.