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A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation

Journal of Human Hypertension volume 31, pages 768–775 (2017)Cite this article

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Abstract

Exercise hypertension is a common occurrence among individuals with aortic coarctation. Although exercise is known to be beneficial among the general population, the risks and benefits of exercise among those with aortic coarctation are less clear. This systematic review evaluates the benefits and risks of exercise for persons with aortic coarctation. Electronic databases were systematically searched (that is, MEDLINE and EMBASE) and key reviews cross-referenced to identify articles for inclusion. Original research articles reporting exercise among individuals with aortic coarctation were included. From 2608 individual citations, 68 eligible articles were identified. Aerobic exercise stress tests were found to be useful for determining exercise hypertension experiences post-surgical repair (N=5), and other long-term secondary findings (N=3). Experiences of exercise hypertension were associated with abnormal cardiac and/or aortic geometry and cardiac function (N=7). Exercise capacity was generally found to be similar to non-aortic coarctation controls post surgery (N=6). Exercise hypertension was experienced by 27% of participants, including 10% of adults and 43% of children/youth. Individuals who experience exercise hypertension experience greater increases in systolic blood pressure with exercise. No investigations identified evaluated forms of exercise other than aerobic stress tests and no exercise training programs have been conducted to date. Exercise stress tests can be valuable in this population for determining exercise hypertension, especially in the year post-surgical repair. Additional research is urgently needed to accurately assess the benefits and risks of exercise and exercise hypertension, and applicability of exercise restrictions for this population.

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Article 05 March 2020

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Acknowledgements

This research was supported by funding from the Systematic Reviews Research Unit at the University of British Columbia. This research was supported by the Canada Foundation for Innovation, the BC Knowledge Development Fund, the Canadian Institutes of Health Research (CIHR), the Michael Smith Foundation for Health Research (MSFHR) and the Natural Sciences and Engineering Research Council of Canada (NSERC). Dr Warburton was supported by a CIHR New Investigator Award and a MSFHR Clinical Scholar Award. HF was supported by the University of Saskatchewan.

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Authors and Affiliations

  1. College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    H J A Foulds

  2. Division of Cardiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

    N B Giacomantonio

  3. Department of Cardiology, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada

    N B Giacomantonio

  4. Physical Activity Promotion and Chronic Disease Prevention Unit, Vancouver, British Columbia, Canada

    S S D Bredin & D E R Warburton

  5. Systematic Reviews Unit, University of British Columbia, Vancouver, British Columbia, Canada

    S S D Bredin

  6. Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, British Columbia, Canada

    D E R Warburton

  7. Department of Medicine, Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    D E R Warburton

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  1. H J A Foulds
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  3. S S D Bredin
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  4. D E R Warburton
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Correspondence to H J A Foulds.

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Foulds, H., Giacomantonio, N., Bredin, S. et al. A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation. J Hum Hypertens 31, 768–775 (2017). https://doi.org/10.1038/jhh.2017.55

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