Hypertension in aortic coarctation

Aortic coarctation (AoC) is a common congenital heart defect, affecting 5%–8% of patients with structural congenital anomalies. Despite advances in surgical and percutaneous interventions, hypertension remains a significant complication in AoC patients, even after successful repair. Chronic hyperten...

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Main Authors: Luisa Ye, Biagio Castaldi, Irene Cattapan, Alice Pozza, Jennifer Fumanelli, Giovanni Di Salvo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1505269/full
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author Luisa Ye
Biagio Castaldi
Irene Cattapan
Alice Pozza
Jennifer Fumanelli
Giovanni Di Salvo
author_facet Luisa Ye
Biagio Castaldi
Irene Cattapan
Alice Pozza
Jennifer Fumanelli
Giovanni Di Salvo
author_sort Luisa Ye
collection DOAJ
description Aortic coarctation (AoC) is a common congenital heart defect, affecting 5%–8% of patients with structural congenital anomalies. Despite advances in surgical and percutaneous interventions, hypertension remains a significant complication in AoC patients, even after successful repair. Chronic hypertension develops in 20%–70% of patients and is a leading cause of long-term cardiovascular morbidity. In these patients, hypertension is associated to renin-angiotensin system activation, residual aortic arch abnormalities, and impaired aortic elasticity. Additionally, exercise-induced hypertension and masked hypertension contribute to adverse outcomes. Management of hypertension in AoC patients requires both perioperative and long-term care. Early after correction, intravenous antihypertensive agents, such as sodium nitroprusside, esmolol, and labetalol, are commonly used to stabilize blood pressure and reduce the risk of complications like cerebral hemorrhage. Oral beta-blockers, ACE inhibitors (ACE-Is), angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) are most commonly used for chronic hypertension. In this review, we discussed about diagnostic workup and therapeutical strategies for hypertension in AoC patients.
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spelling doaj-art-e2b4115c7e7b4a85a29fae4b8b58d5f12025-08-20T02:25:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-04-011210.3389/fcvm.2025.15052691505269Hypertension in aortic coarctationLuisa YeBiagio CastaldiIrene CattapanAlice PozzaJennifer FumanelliGiovanni Di SalvoAortic coarctation (AoC) is a common congenital heart defect, affecting 5%–8% of patients with structural congenital anomalies. Despite advances in surgical and percutaneous interventions, hypertension remains a significant complication in AoC patients, even after successful repair. Chronic hypertension develops in 20%–70% of patients and is a leading cause of long-term cardiovascular morbidity. In these patients, hypertension is associated to renin-angiotensin system activation, residual aortic arch abnormalities, and impaired aortic elasticity. Additionally, exercise-induced hypertension and masked hypertension contribute to adverse outcomes. Management of hypertension in AoC patients requires both perioperative and long-term care. Early after correction, intravenous antihypertensive agents, such as sodium nitroprusside, esmolol, and labetalol, are commonly used to stabilize blood pressure and reduce the risk of complications like cerebral hemorrhage. Oral beta-blockers, ACE inhibitors (ACE-Is), angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) are most commonly used for chronic hypertension. In this review, we discussed about diagnostic workup and therapeutical strategies for hypertension in AoC patients.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1505269/fullaortic coarctationhypertensionhypertension in congenital heart diseasescongenital heart diseasessurgical repairstent implantation
spellingShingle Luisa Ye
Biagio Castaldi
Irene Cattapan
Alice Pozza
Jennifer Fumanelli
Giovanni Di Salvo
Hypertension in aortic coarctation
Frontiers in Cardiovascular Medicine
aortic coarctation
hypertension
hypertension in congenital heart diseases
congenital heart diseases
surgical repair
stent implantation
title Hypertension in aortic coarctation
title_full Hypertension in aortic coarctation
title_fullStr Hypertension in aortic coarctation
title_full_unstemmed Hypertension in aortic coarctation
title_short Hypertension in aortic coarctation
title_sort hypertension in aortic coarctation
topic aortic coarctation
hypertension
hypertension in congenital heart diseases
congenital heart diseases
surgical repair
stent implantation
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1505269/full
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AT biagiocastaldi hypertensioninaorticcoarctation
AT irenecattapan hypertensioninaorticcoarctation
AT alicepozza hypertensioninaorticcoarctation
AT jenniferfumanelli hypertensioninaorticcoarctation
AT giovannidisalvo hypertensioninaorticcoarctation