Increased forearm vascular reactivity in patients with hypertension after repair of coarctation

Abstract

To determine whether altered vascular reactivity could contribute to hypertension after repair of coarctation, the change in forearm and calf vascular resistances to small intra-arterial infusions of norepinephrine were measured in 6 patients who had undergone surgical correction of coarctation of the aorta but still had upper extremity hypertension and compared with similar measurements made in 5 normotensive patients with mild heart disease. Only the mean upper extremity pressure was significantly greater in the group that underwent repair of coarctation (102 ± 11 vs 83 ± 5 mm Hg, p < .05). There was no difference between the 2 groups with regard to the dose-response curves for calf vascular resistance. These data suggest the presence in the resistance vessels anatomically positioned above the coarctation of abnormal vascular reactivity that may have persisted despite successful repair.