Mild Coarctation of Aorta is an Independent Risk Factor for Exercise-Induced Hypertension

Alexander C. Egbe, Thomas G. Allison, Naser M. Ammash

Research output: Contribution to journalArticle

Abstract

Exercise-induced hypertension is a predictor of cardiovascular events in patients with coarctation of aorta (COA). However, it is unclear whether mild COA diagnosis is an independent risk factor of exercise-induced hypertension. We hypothesized that for every unit increase in exercise, patients with COA (without hemodynamically significant coarctation) will have a higher rise in systolic blood pressure (SBP) compared with matched controls. One hundred forty-nine patients with COA (aortic coarctation peak velocity <2 m/s) who underwent exercise testing were matched 1:1 to controls using propensity score method based on age, sex, body mass index, hypertension diagnosis, and SBP at rest. We compared exercise-induced change in SBP between patients with COA and controls and also assessed the correlation between Doppler-derived aortic vascular function indices (effective arterial elastance index and total arterial compliance index) and exercise-induced changes in SBP. Compared with controls, patients with COA had a greater change in SBP per unit metabolic equivalent (β=2.86; 95% CI, 1.96-4.77 versus 1.07, 95% CI, -0.15 to 1.75; P=0.018) and per unit oxygen pulse (β=4.57; 95% CI, 2.97-7.12 versus 1.45, 95% CI, -0.79 to 2.09, P<0.001). There was a correlation between SBPpeak-SBPrest and elastance index (r=0.38, P=0.032) and between SBPpeak-SBPrest and total arterial compliance index (r=-0.51, P=0.001), suggesting an association between vascular dysfunction and exercise-induced BP changes. Patients with COA, without significant obstruction, had higher exercise-induced changes in SBP after adjustment for other risk factors for hypertension. Considering the already known prognostic importance of exercise-induced hypertension, the current study highlights the potential role of exercise testing for risk stratification of patients with mild COA.

Original languageEnglish (US)
Pages (from-to)1484-1489
Number of pages6
JournalHypertension (Dallas, Tex. : 1979)
Volume74
Issue number6
DOIs
StatePublished - Dec 1 2019

Fingerprint

Aortic Coarctation
Exercise
Blood Pressure
Hypertension
Compliance
Blood Vessels
Metabolic Equivalent
Propensity Score
Body Mass Index

Keywords

  • aortic coarctation
  • blood pressure
  • exercise
  • hypertension
  • risk factor

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Mild Coarctation of Aorta is an Independent Risk Factor for Exercise-Induced Hypertension. / Egbe, Alexander C.; Allison, Thomas G.; Ammash, Naser M.

In: Hypertension (Dallas, Tex. : 1979), Vol. 74, No. 6, 01.12.2019, p. 1484-1489.

Research output: Contribution to journalArticle

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