Hypertension after repair of aortic coarctation - A systematic review

Hypertension continues to be a common and potentially serious problem in patients who have undergone anatomically successful repair of aortic coarctation.ObjectiveTo assess the prevalence of hypertension after aortic coarctation repair, the factors that affect the prevalence and the hypotheses behind hypertension in this cohort of patients.DesignA systematic review of all articles reporting on systolic blood pressure (SBP) in patients who have undergone aortic coarctation repair.Data sourcesAn electronic search of all English articles using PUBMED and The Cochrane Controlled Trials Register was performed. A manual search of references lists of relevant studies and a search of conference abstracts were also conducted.Inclusion criteriaWe restricted inclusion to articles published between 1987 and 2012 that reported on SBP in patients who have undergone aortic coarctation repair.Data extractionIndependent extraction of articles was performed by two authors using predefined data fields. One author then proceeded to extract information of interest from these articles.ResultsThe first search yielded 12,914 articles. After screening titles, abstracts and full text articles 26 articles were included in this review article. In papers reporting the prevalence of hypertension late after anatomically satisfactory coarctation repair, the median prevalence was 32.5% (range 25-68%).ConclusionHypertension remains a common complication following aortic coarctation repair. Factors that influence the reported prevalence of hypertension include the age at the time of surgery, age at follow up, the method used to measure blood pressure and the type of intervention performed.