A long term risk exists for development of systemic hypertension, despite successful coarctation repair, particularly when repair occurs after age ten years. This may result from systemic vascular effects caused by years of hypertension.
Care must be taken, however, to be sure that no residual obstruction exists. Remember that in a normal supine adult patient systolic blood pressure in the foot measures at least 10 mmHg higher than that in the arm. Measurement of blood pressure in the arm and leg during exercise may be necessary in order to identify a residual obstruction.