Ambulatory blood pressure data is the best approximation of central aortic pressure in coarctation of aorta.

The purpose of the study was to determine which out-of-office BP measurement modality has the best correlation with central aortic systolic BP, arterial stiffness (a determinant of central aortic pressure) and LV mass index (LVMI) which represents LV adaptation to elevated central aortic pressures. In this prospective study, we demonstrated that 24h ambulatory systolic BP has better correlation with central aortic systolic BP (arterial load) and LVMI as compared to home systolic BP. 24h ambulatory systolic BP also correlated with arterial stiffness (determinant of arterial load), although this correlation was comparable to that observed with home systolic BP. Collectively, these results suggest that ambulatory systolic BP provides the best approximation of arterial load, which is the underpinning hemodynamic stress leading to LV remodeling, end-organ dysfunction, and cardiovascular mortality in patients with COA. These findings provide a foundation for further studies to determine whether titrating antihypertensive therapy based on ambulatory BP indices will slow the progression of LV remodeling and end-organ dysfunction due to hypertension, and in turn, reduce cardiovascular death in this population.