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REVIEW article
Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1505269
This article is part of the Research Topic Imaging, diagnosis and interventional treatment of congenital heart disease in children View all 5 articles
Hypertension in Aortic Coarctation
Provisionally accepted- Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
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.
Keywords: Aortic Coarctation, Hypertension, hypertension in congenital heart diseases, Congenital heart diseases, surgical repair, Stent implantation
Received: 02 Oct 2024; Accepted: 19 Mar 2025.
Copyright: © 2025 Ye, Castaldi, Cattapan, Pozza, Fumanelli and Di Salvo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Biagio Castaldi, Pediatric Cardiology Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
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