Exercise capacity in young adults with hypertension and systolic blood pressure difference between right arm and leg after repair of coarctation of the aorta

Authors: Instebø, Arne1; Norgård, Gunnar1; Helgheim, Vegard1; Røksund, Ola1; Segadal, Leidulf2; Greve, Gottfried3

Source: European Journal of Applied Physiology, Volume 93, Numbers 1-2, October 2004 , pp. 116-123(8)

Publisher: Springer

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Abstract:

Coarctation of the aorta represents 5–7% of congenital heart defects. Symptoms and prognosis depend on the degree of stenosis, age at surgery, surgical method and the presence of other heart defects. Postoperative complications are hypertension, restenosis and an abnormal blood pressure response during exercise. This study includes 41 patients, 15–40 years old, operated in the period 1975–1996. All were exercised on a treadmill until maximal oxygen consumption was achieved. Blood pressure was measured in the right arm and leg before and immediately after exercise, and in the right arm during exercise. Oxygen consumption was monitored and we defined an aerobic phase, an isocapnic buffering phase and a hypocapnic hyperventilation phase. The resting systolic blood pressure correlates with the resting systolic blood pressure difference between right arm and leg. A resting systolic blood pressure difference between the right arm and leg of 0.13 kPa (1 mmHg) to 2.67 kPa (20 mmHg) corresponds with a slight increase in resting systolic blood pressure. This rise in blood pressure increases the aerobic phase of the exercise test, helping the patients to achieve higher maximal oxygen consumption. A resting systolic blood pressure difference of more than 2.67 kPa (20 mmHg) corresponds with severe hypertension and causes reduction in the aerobic phase and maximal oxygen consumption. Resting systolic blood pressure and resting systolic blood pressure difference between the right arm and leg are not indicators for blood pressure response during exercise. Exercise testing is important to reveal exercise-induced hypertension and to monitor changes in transition from aerobic to anaerobic exercise and limitation to exercise capacity.

Keywords: Anaerobic threshold; Oxygen consumption; Blood pressure

Document Type: Research article

DOI: 10.1007/s00421-004-1180-8

Affiliations: 1: Department of Paediatrics, Haukeland University Hospital, 5020 , Bergen, Norway, 2: Department of Heart Disease, Haukeland University Hospital, 5020 , Bergen, Norway, 3: Department of Paediatrics, Haukeland University Hospital, 5020 , Bergen, Norway, Email: gottfried.greve@helse-bergen.no

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