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High pulse pressure is not associated with abnormal activation of the renin–angiotensin–aldosterone system in repaired aortic coarctation

Journal of Human Hypertension volume 29, pages 268–273 (2015)Cite this article

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Abstract

We investigated the relationship between pulse pressure (PP)—a surrogate marker of arterial stiffness—and activity of the renin–angiotensin–aldosterone system (RAAS) in adult patients with repaired coarctation and normal left ventricular (LV) function. A total of 114 patients (44 (26–74) years, 13 (0.1–40) years at repair) and 20 healthy controls were examined with 24-h ambulatory blood pressure monitoring, echocardiography, vasoactive hormone levels and magnetic resonance of the thoracic aorta. Forty-one patients (36%) were taking antihypertensives (28 RAAS inhibitors). Fifty-one had mean 24-h blood pressures >130/80 mm Hg. Hypertension was not associated with age at repair (P=0.257). Patients had higher PP and LV mass compared with controls (52±11 vs 45±5 mm Hg and 221±71 vs 154±55 g, respectively; both P<0.05). Differences were more pronounced in the presence of recoarctation, but independently of RAA levels. Even normotensive patients had higher LV mass than controls. LV mass and recoarctation were correlated with PP levels. In conclusion, adult patients with repaired coarctation have increased PP and LV mass compared with controls. PP increased with increasing recoarctation. Hypertension was present also in the absence of recoarctation. These changes could not be explained by abnormal activation of the RAAS.

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Authors and Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark

    T A L Pedersen & V E Hjortdal

  2. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    T A L Pedersen, K Munk, K Emmertsen & N H Andersen

  3. Departments of Medical Research and Medicine, Holstebro Hospital, Holstebro, Denmark

    E B Pedersen

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  1. T A L Pedersen
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  4. V E Hjortdal
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Correspondence to T A L Pedersen.

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Pedersen, T., Pedersen, E., Munk, K. et al. High pulse pressure is not associated with abnormal activation of the renin–angiotensin–aldosterone system in repaired aortic coarctation. J Hum Hypertens 29, 268–273 (2015). https://doi.org/10.1038/jhh.2014.75

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