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Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
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Systemic hypertension and non-cardiac surgery.

Satyajeet Misra1

  • 1Department of Anaesthesiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Indian Journal of Anaesthesia
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PubMed
Summary

Primary systemic hypertension is common in surgical patients, but risks are low if blood pressure remains below 180/110 mmHg. This review focuses on managing chronic hypertension during elective non-cardiac surgery.

Keywords:
Anaesthesiacomplicationshypertensive emergencieshypertensive heart diseasesystemic hypertension

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Nephrology

Background:

  • Primary systemic hypertension impacts 10-25% of surgical patients, often leading to elective surgery cancellations.
  • Fear of adverse perioperative outcomes in hypertensive patients is common.
  • While chronic hypertension increases long-term risks (stroke, renal dysfunction, cardiovascular events), perioperative risks are generally low if blood pressure is <180/110 mmHg.

Purpose of the Study:

  • To review perioperative concerns for adult patients with chronic primary systemic hypertension undergoing elective non-cardiac surgery.
  • To highlight current guidelines on perioperative blood pressure management.
  • To discuss newer risk stratification concepts like isolated systolic hypertension and pulse pressure hypertension.

Main Methods:

  • Literature review focusing on primary systemic hypertension in the context of elective non-cardiac surgery.
  • Analysis of current guidelines and newer risk stratification concepts.
  • Synthesis of information on perioperative management strategies.

Main Results:

  • Blood pressure <180/110 mmHg is generally considered safe in the perioperative period, despite long-term hypertension risks.
  • Isolated systolic hypertension and pulse pressure hypertension are emerging as important risk stratification tools.
  • Management strategies aim to mitigate perioperative risks associated with hypertension.

Conclusions:

  • Patients with chronic primary systemic hypertension can often undergo elective non-cardiac surgery safely if blood pressure is well-controlled (<180/110 mmHg).
  • Understanding and applying newer risk stratification methods is crucial for optimal patient care.
  • This review provides a focused overview for managing perioperative concerns in this patient population.