Abstract 14229: Increased Incidence of Obesity Following Repair of Coarctation of the Aorta
Background: Obesity is associated with hypertension and atherosclerotic cardiovascular disease, conditions that occur at an accelerated rate after repair of coarctation of the aorta (COA).
Objective: To establish the incidence of obesity in patients with COA and to determine if obesity is a major factor in the development of hypertension in COA.
Methods: A review of 226 patients with COA (age 4.6-41 years, 15.7±7.2 years) and 46 adults with isolated aortic stenosis (AS) (26.1±6.4 years), 11 adults with isolated pulmonary stenosis (PS) (21.7±6.6 years) and 11 adults with atrial septal defect (ASD) (23±3.3 years) who were regularly followed at our institution was performed. Height, weight, body mass index z-score (BMIz) and systolic blood pressure z-score (SBPz) were obtained from the most recent clinic visit, and when possible, from clinic visits at age 5, 10, 15, and 20 years of age.
Results: Individuals with COA have a BMIz which increases with age (p<0.001) and an increased incidence of being either overweight or obese (30% of COA patients at age 15, and 71% at > 20). After age 5, the incidence rate of developing obesity in COA pts was 0.052. After age 10, patients with COA also have a BMI distribution that is shifted to the right when compared to the general population (p<0.001). Adults with AS, PS or ASD had a significantly lower incidence of obesity at age 15 and 20 years (p<0.01 and 0.001) and did not increase their BMIz with age. In patients with COA, 40% of the increase in SBPz over time was related to the increase in BMIz (p<0.001), (i.e. for a one unit increase in BMIz, we saw a 2.7% increase in SBPz every year from age 5-20).
Conclusion: Patients with repaired COA have a higher incidence of obesity when compared to the general population. The incidence of obesity in this population increases with age. An increase in BMI appears to be associated with later development of hypertension.
- © 2011 by American Heart Association, Inc.