Hypertension in Aortic Coarctation

Patients with aortic coarctation are prone to develop arterial hypertension at various stages throughout life. There are at least three different pathophysiologic pathways: re-stenosis at the aortic isthmus, paradoxical hypertension, and late hypertension at long-term follow-up. As the most common causes of death reported for coarctation patients are linked to hypertension, it is important to differentiate these pathways of hypertension carefully to provide optimal treatment for hypertensive coarctation patients. This review summarizes the actual data about those different pathologic pathways, about how to differentiate them from each other, and how to treat them adequately.