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Carotid intima–media thickness in post-coarctectomy patients with exercise induced hypertension
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  1. J W J Vriend1,
  2. E de Groot2,
  3. B J Bouma1,
  4. J Hrudova1,
  5. J J P Kastelein2,
  6. J G P Tijssen1,
  7. B J M Mulder1
  1. 1Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
  2. 2Department of Vascular Medicine, Academic Medical Center
  1. Correspondence to:
    Dr Barbara J M Mulder
    Department of Cardiology, Room B2–240, Academic Medical Center Amsterdam, PO box 22700, 1100 DE Amsterdam, The Netherlands; b.j.mulderamc.uva.nl

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The significance of exercise blood pressure in post-coarctectomy patients and its relation to clinical outcome and organ damage is still unknown. Several authors have suggested that patients with exercise induced hypertension might be amenable to antihypertensive medication or limitation of strenuous physical activity.1 However, recently Swan and colleagues2 discouraged the use of exercise testing for the assessment of blood pressure profiles in these patients. Intima–media thickness (IMT) is nowadays considered a validated and reproducible end point for atherosclerosis.3 The aim of the present study was to investigate the relation between exercise induced hypertension and carotid IMT in adult post-coarctectomy patients.

METHODS

From 2001 until 2002, all 137 consecutive adult post-coarctectomy patients (89 male) from our tertiary referral centre participated in this study. The protocol was approved by the institutional review committee and informed consent was obtained from all participants. In all patients significant residual aortic stenosis or re-coarctation had been ruled out by magnetic resonance imaging within two years of the start of this study. Risk factors for atherosclerosis, such as smoking and serum lipids, were assessed. All patients underwent 24 hour ambulatory blood pressure monitoring in the right arm. Patients were considered hypertensive when mean daytime systolic blood pressure was …

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