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Pediatric Cardiology

, Volume 39, Issue 1, pp 1–10 | Cite as

Hypertension in Coarctation of the Aorta: Challenges in Diagnosis in Children

  • Trisha V. Vigneswaran
  • Manish D. Sinha
  • Israel Valverde
  • John M. Simpson
  • Marietta CharakidaEmail author
Review Article

Abstract

Evidence indicates that patients with coarctation of the aorta (COA) suffer from increased cardiovascular morbidity and mortality in later life despite successful repair of COA in childhood. Systolic arterial hypertension is common, presenting in up to one-third of patients, and is regarded as the main driver of premature cardiovascular events in this group of patients. In this review, we discuss the prevalence and pathophysiology of hypertension in children following successful COA repair with no residual arch obstruction. The challenges in accurate blood pressure assessment at this early phase are considered and non-invasive measures of central blood pressure are discussed. Although the pathways for investigations in adults are well defined, we highlight the need to address the issues of cardiovascular surveillance in children and describe techniques which can provide complementary information for cardiovascular assessment in this group of patients such that timely treatment can occur.

Keywords

Coarctation of the aorta Hypertension Central blood pressure Vasculopathy Arterial stiffness Paediatric 

Abbreviations

COA

Coarctation of the aorta

BP

Blood pressure

ABPM

Ambulatory blood pressure monitoring

Notes

Compliance with Ethical Standards

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Trisha V. Vigneswaran
    • 1
    • 2
  • Manish D. Sinha
    • 3
  • Israel Valverde
    • 1
    • 2
    • 4
  • John M. Simpson
    • 1
    • 2
  • Marietta Charakida
    • 1
    • 2
    Email author
  1. 1.Department of Congenital Heart DiseaseEvelina London Children’s Hospital, Guy’s & St Thomas’ HospitalsLondonUK
  2. 2.Division of Imaging Sciences, Kings College London British Heart Foundation CentreNIHR Biomedical Research Centre at Guy’s & St Thomas’ NHS Foundation TrustLondonUK
  3. 3.Department of Paediatric NephrologyEvelina London Children’s Hospital, Guy’s & St Thomas’ HospitalsLondonUK
  4. 4.Cardiovascular Pathology Unit, Institute of Biomedicine of Seville, IBISVirgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain

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