The following is the summary of “On-treatment blood pressure and cardiovascular mortality in adults with repaired coarctation of aorta” published in the January 2023 issue of Heart by Egbe, et al.
While hypertension is prevalent in adults with aortic repair for coarctation of the aorta (COA), there is a lack of information regarding on-treatment blood pressure (BP) and its association with outcomes in this cohort. Researchers wanted to see how high blood pressure (BP) while on therapy affected the risk of death from cardiovascular causes in adults who had their COA repaired. Antihypertensive treatment patients with corrected COA (n=461, age, 39 11) were analyzed retrospectively. On-treatment BP was calculated by averaging all readings taken within the first 3 years of treatment, and patients were then placed into BP quartiles according to the recommendations’ cutoff thresholds.
Systolic blood pressure (SBP) in the upper quartiles (SBP 120-129, 130-139, and 140) was linked with an increased risk of cardiovascular mortality (hazard ratio [HR], 1.05; 95% CI, 1.01-1.07; HR, 1.12; 95% CI, 1.04-1.15; HR, 1.39; 95% CI, 1.13-1.59). Investigators found that for every 5 mmHg increase in SBP and for every 4 mmHg increase in DBP, the risk of cardiovascular death rose by 7% and 4%, respectively.
Collectively, these results imply that even a milder form of hypertension, SBP (120-129 mmHg), is not benign and may warrant antihypertensive treatment. However, the best type and degree of antihypertensive therapy, as well as whether or not this group of patients (SBP 120 to 129 mmHg) will benefit from antihypertensive therapy, can only be determined by a randomized controlled clinical trial.