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Is Peri-Operative Isolated Systolic Hypertension (ISH) a Cardiac Risk Factor?

Ashraf Fayad1, Homer Yang

  • 1Department of Anesthesiology and Perioperative Medicine, University of Ottawa, 1053 Carling Ave. (B3), The Ottawa Hospital, Ottawa, Ontario, Canada, K1Y 4E9.

Current Cardiology Reviews
|November 20, 2009
PubMed

Insights

Isolated Systolic Hypertension (ISH) is a significant cardiovascular risk factor, particularly in the perioperative period. Further research is needed to understand its impact on surgical patients and improve outcomes.

Area of Science:

  • Cardiology
  • Geriatrics
  • Anesthesiology

Background:

  • Isolated Systolic Hypertension (ISH) is common in aging populations and linked to increased cardiac and cerebrovascular events.
  • ISH is associated with left ventricular (LV) changes, including hypertrophy (LVH) and diastolic dysfunction (DD).
  • Perioperative cardiac complications are a major concern, especially in lower-risk patients.

Purpose of the Study:

  • To review Isolated Systolic Hypertension (ISH) as a cardiovascular risk factor.
  • To emphasize the under-recognized role of ISH in the perioperative setting.
  • To highlight the need for further investigation into perioperative ISH.

Main Methods:

  • Literature review of Isolated Systolic Hypertension (ISH).
  • Analysis of ISH's association with cardiovascular events and LV changes.
  • Discussion of ISH in the context of perioperative cardiac complications.

Main Results:

  • ISH is the most frequent hypertension subtype (65%) in uncontrolled cases and carries higher risks than diastolic hypertension.
  • LVH and DD are common in ISH patients, increasing cardiovascular event risk.
  • Essential hypertension is not a significant perioperative risk factor in most studies, but perioperative ISH is under-studied.

Conclusions:

  • ISH is an under-recognized perioperative risk factor.
  • Further research, such as the PROMISE Study, is crucial to understand and manage perioperative ISH.
  • Managing elevated systolic blood pressure in ISH patients can reduce cardiovascular event risk.

Keywords:
Isolated systolic hypertensioncardiovascular risk factorsperioperative.

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