Year: 2023
Type: article
Study design: Observational Study
Abstract: Hypertension is present in more than half of adults with repaired coarctation of aorta (COA), and it is a major determinant of clinical outcomes.1 Systolic blood pressure (SBP) derived from 24-hour ambulatory BP monitoring correlates more strongly with aortic stiffness, central aortic pressure, left ventricular (LV) remodeling and cardiovascular adverse events as compared to office BP and home BP measurements.2, 3 However, the 24-hour ambulatory BP is not monophasic, but rather measures BP across two distinct phases of the circadian cycle, with daytime BP showing BP response during activities of daily living, and nighttime BP showing the expected nocturnal decrease in BP during sleep.2, 3 In patients with acquired heart disease, nighttime BP measurements has superior prognostic performance (as compared to daytime BP measurements) across different cardiovascular outcomes.Similar data are lacking in adults with repaired COA, and this represents an important knowledge gap considering the high prevalence of hypertension in this population.Based on data from the acquired heart disease population, we hypothesized that nighttime SBP from 24-hour ambulatory BP monitoring is more strongly correlated with indices of left heart remodeling at baseline, and cardiovascular adverse events during follow-up.To test this hypothesis, we studied adults with repaired COA without significant residual COA (COA mean gradient ≤20 mmHg) or left-sided valve disease (mitral mean gradient ≤5 mmHg, aortic mean gradient ≤20 mmHg, <moderate aortic or mitral regurgitation), who underwent 24-hour ambulatory BP and echocardiogram at Mayo Clinic (2003-2020).Ambulatory BP measurement was performed using Ultralite Ambulatory-BP-902017
Source: Hypertension
Institution: Mayo Clinic
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4376114939