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Updated: Jun 22, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
[Systemic hypertension and anesthesia.]
Michelle Nacur Lorentz1, Alexandre Xavier Santos
1Biocor Instituto.
Insights
For patients with systemic hypertension undergoing elective surgery, clear guidelines on acceptable blood pressure levels before anesthesia are lacking. Decisions to cancel surgery should prioritize organ damage over specific blood pressure readings.
Area of Science:
- Anesthesiology
- Cardiology
- Internal Medicine
Context:
- Systemic hypertension is common, yet consensus on pre-anesthesia blood pressure thresholds for elective procedures is absent.
- Surgical cancellations due to uncontrolled hypertension incur significant costs and logistical challenges.
- Ensuring safe anesthesia induction is paramount, necessitating evidence-based practice guidelines.
Purpose:
- To review existing literature on hypertension and anesthesia for elective procedures.
- To provide evidence-based guidance for clinical practice regarding pre-anesthesia blood pressure management.
- To address the lack of consensus on acceptable blood pressure levels before inducing anesthesia.
Summary:
- Literature review indicates no established maximum blood pressure levels for elective procedures.
- Current criteria for canceling surgery in hypertensive patients often rely on empirical data rather than robust evidence.
- A trend exists to cancel procedures if blood pressure exceeds 180/110 mmHg, but individualized assessment is crucial.
Impact:
- Highlights the need for evidence-based guidelines to optimize patient safety and resource allocation in anesthesia.
- Emphasizes individualized patient assessment, focusing on target-organ injury rather than solely on blood pressure values.
- Aims to reduce unnecessary surgical delays and associated healthcare costs by informing clinical decision-making.
Background And Objectives:
Due to the high incidence of systemic hypertension and the lack of consensus on pressure levels to be accepted before inducing anesthesia for elective procedures, literature associated to hypertension and anesthesia was reviewed. Considering that canceling a surgery implies expenses making Medicine increasingly more expensive and that, on the other hand, anesthesia should be induced in the safest possible manner, this study aimed at evaluating literature evidences to orient clinical practice.
Contents:
Incidence and classification of systemic hypertension in addition to reports and comments on relevant studies approaching hypertension in surgical patients are presented.
Conclusions:
Maximum pressure levels compatible with elective procedures are still not established and today criteria to cancel surgery of poorly controlled hypertensive patients are more based on empirical data than on evidences. There is a trend to cancel the procedure when BP is above 180/110 mmHg, but situations should be evaluated in a case-by-case basis, giving more importance to target-organs injury than to blood pressure itself.
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