In normal subjects the systolic blood pressure (SBP) is lower in the arms than in the legs because of peripheral amplification of the pulse pressure.^1,2 The criteria for a successful repair of coarctation of the aorta include normal blood pressure (BP) and no resting arm–leg pressure gradient.³ Some patients may develop an arm–leg pressure gradient only with exercise; thus, the diagnostic role of the exercise test after repair is important.³ Recently, an exercise study of post-coarctation patients reported the development of a post-exercise arm–leg SBP gradient in healthy controls.⁴ On the basis of their results, the authors questioned the role of measuring an exercise arm–leg pressure gradient to evaluate the success of a coarctation repair. We think that their results were spurious because of the methods used. The objective of our study was to determine whether healthy children develop an arm–leg SBP gradient with exercise.

METHODS

We recruited 12 healthy children between 10 and 17 years of age. The subjects were asked to rest on a recumbent cycle ergometer (Lode BV, Groningen, The Netherlands) for 5 min before we obtained resting measurements. Their ECGs were monitored before, during and after exercise. Appropriately sized BP cuffs (Baum Co Inc, Copiague, New York, USA) were placed on the …