ORIGINAL ARTICLESAntihypertensive therapy of late arterial hypertension in children following successful coarctation correctionSendzikaite, Skaistea; Sudikiene, Ritaa; Lubaua, Ingunab; Silis, Paulsb; Rybak, Agatac; Brzezinska-Rajszys, Grazynac; Obrycki, Łukaszd; Litwin, Mieczysławd; Jankauskiene, Augustinaa Author Information aInstitute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania bClinic for Paediatric Cardiology and Cardiac Surgery, Children's Clinical University Hospital, Stradins University, Riga, Latvia cDepartment of Cardiology dDepartment of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland Correspondence to Skaiste Sendzikaite, Santariskiu str. 2, Vilnius 08410, Lithuania. Tel: +37067124784; e-mail: [email protected] Abbreviations: ABPM, ambulatory blood pressure monitoring; ACEi, angiotensin-converting enzyme inhibitors; AH, arterial hypertension; BP, blood pressure; CCB, calcium channel blocker; CoA, coarctation of the aorta; cSBP, central systolic BP; LVH, left ventricular hypertrophy; LVMi, left ventricular mass index; RWT, relative wall thickness; SDS, standard deviation score; WCH, white-coat hypertension Received 4 February, 2022 Revised 4 July, 2022 Accepted 25 July, 2022 Journal of Hypertension 40(12):p 2476-2485, December 2022. | DOI: 10.1097/HJH.0000000000003282 Buy Metrics Abstract Backgroung: Late arterial hypertension (AH) is the most significant complication of coarctation of the aorta (CoA). Only a few clinical studies described antihypertensive treatment of late AH following successful CoA repair. The primary objective of this multicentre cross-sectional study was to describe real-life antihypertensive therapy for late AH in children after hemodynamically successful CoA repair. The secondary objective was to describe antihypertensive therapy used within different haemodynamic phenotypes of AH. Method: Blood pressure status, echocardiographic parameters and central blood pressure measurements were evaluated in 110 children aged 6–18 years following successful CoA repair with right arm blood pressure not exceeding leg blood pressure by at least 20 mmHg. Results: AH was found in 62 (56%) patients including 47 who were already treated and 15 with new diagnosed AH of whom seven presented with masked hypertension. Among treated patients, 10 presented with masked hypertension. The dominant phenotype of AH among patients with uncontrolled AH was isolated systolic hypertension (32 patients out of 37; 87.5%). AH was controlled in 53% of treated patients. Fifty-three percent of hypertensive patients had elevated central SBP and 39% had left ventricular hypertrophy with various left ventricle geometry patterns, 23% of them had both. β-adrenergic receptor blockers were the most used antihypertensive drugs followed by angiotensin-converting enzyme inhibitors with doses within the lower recommended range. Conclusion: High prevalence of uncontrolled AH despite successful CoA repair and use of relatively low doses of antihypertensive drugs indicates the need of close blood pressure monitoring and more intensive and combined antihypertensive therapy. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.