Blood Pressure in Adults with Congenital Heart Disease

Background：We previously reported enhanced pressure wave reflection in adult patients with congenital heart disease, which can result in high systolic blood pressure. Although hypertension could cause significant damage to vulnerable systemic ventricles, few studies have reported on blood pressure in adults with congenital heart disease thus far. The purpose of this study was to investigate the incidence and risk factors associated with hypertension in adult patients with congenital heart disease. Methods and Results：One-hundred and thirty-one adults with congenital heart disease were enrolled in this study. Brachial blood pressure was measured using an HEM-9000AI system (Omron Healthcare Co., Ltd., Kyoto, Japan). Patients with systolic/diastolic blood pressure ≥140/90 mmHg or those taking medication for hypertension were defined as hypertension. A systolic blood pressure ≥ +2 SD of systolic blood pressure in the age- and sex-matched general population was defined as high systolic blood pressure. The patients were aged 37.0 ± 15.0 years. Hypertension was observed in sixteen patients (16%), and logistic regression analysis revealed that the determinant of hypertension was age (years) (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.029-1.129; p = 0.001). High systolic blood pressure was observed in twenty patients (20%). Logistic regression analysis revealed that the determinants of high systolic blood pressure were age (years) (OR, 1.072; 95%CI, 1.020-1.126; p = 0.016) and body mass index (kg/m2) (OR, 1.261; 95% CI, 1.054-1.508; p = 0.011). The body mass index in young patients (≤ 30 years) with high systolic blood pressure was remarkably high (31.2 ± 3.0 kg/m2). Conclusions：The incidence of high systolic blood pressure is high in adult patients with congenital heart disease. High systolic blood pressure is common in older patients and is associated with a high body mass index in young patients.