Document Detail

Atenolol therapy for exercise-induced hypertension after aortic coarctation repair.
MedLine Citation:
PMID:  2239728     Owner:  NLM     Status:  MEDLINE    
After successful repair of coarctation of the aorta in childhood, exercise-induced upper body systolic hypertension is well documented. Beta blockade has been shown to reduce the arm/leg gradient in untreated coarctation of the aorta; treatment before coarctation repair has decreased paradoxical hypertension after repair. Ten patients with successful surgical repair of coarctation, defined as a resting arm/leg gradient of less than or equal to 18 mm Hg, were evaluated by treadmill exercise before and after beta blockade with atenolol. Mean age was 5.5 years at repair and 18 at study. At baseline evaluation, systolic blood pressures at termination of exercise ranged from 201 to 270 mm Hg (mean 229 mm Hg). Arm/leg gradients at exercise termination ranged from 30 to 143 mm Hg (mean 84). Follow-up treadmill exercise studies were performed after beta blockade. Upper extremity systolic pressures at exercise termination were normalized in 9 of 10 patients. Maximal systolic blood pressure recorded at exercise termination ranged from 163 to 223 mm Hg (mean 196 mm Hg, p less than or equal to 0.005). Arm/leg gradient at termination of exercise also decreased significantly to a mean of 51 mm Hg (p less than 0.05). No patient had symptoms on atenolol and exercise endurance times were unchanged. The study results in this small series suggest that cardioselective beta blockade can be used to treat exercise-induced upper body hypertension effectively after surgical repair of coarctation. Because a high incidence of premature cardiovascular disease has been well documented after satisfactory surgical repair, the findings are of importance for this group of postoperative patients.
R E Kavey; J L Cotton; M S Blackman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  66     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-14     Completed Date:  1990-12-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1233-6     Citation Subset:  AIM; IM    
Division of Pediatric Cardiology, State University of New York Health Science Center, Syracuse 13210.
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MeSH Terms
Aortic Coarctation / physiopathology,  surgery*
Arm / blood supply
Atenolol / therapeutic use*
Blood Pressure Determination
Exercise Test
Hypertension / drug therapy*,  etiology
Leg / blood supply
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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