This week we return to the world of adult congenital heart disease to review 2 related works on the topic of late cardiovascular risks in patients who have undergone prior coarctation repair. Are such patients at elevated risk for early coronary artery disease and stroke? What are the causes for these late complications? What role does hypertension play in the development of these late sequelae? Are there other factors that may explain these risks and how should patients be screened for these issues? These are amongst the questions we review with Dr. Sarah Pickard, Instructor in Pediatrics, Harvard Medical School and first author of 2 important new works from the team at Boston Children's Hospital and Brigham and Women's Hospital. doi: 10.1016/j.amjcard.2018.08.051 and doi: 10.1161/JAHA.118.009072