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Preoperative Hypertension

Simon James Howell1

  • 1Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF UK.

Current Anesthesiology Reports
|March 13, 2018
PubMed

Insights

New hypertension guidelines emphasize ambulatory blood pressure monitoring over single preoperative readings. While low blood pressure during surgery increases risk, deferring surgery for hypertension above 180/100 mmHg is not advised without comorbidities.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Surgical Management

Background:

  • Recent hypertension guidelines advocate for ambulatory blood pressure measurement.
  • Isolated preoperative blood pressure readings have limited clinical value.

Purpose of the Study:

  • To review the implications of new hypertension guidelines for perioperative management.
  • To contextualize guideline changes with findings from large observational studies.

Main Methods:

  • Review of current hypertension guidelines.
  • Analysis of recent large observational studies on blood pressure and surgical outcomes.

Main Results:

  • Ambulatory blood pressure monitoring is highlighted by new guidelines.
  • Both preoperative and intraoperative hypotension are linked to increased surgical risk.
  • The specific risk of hypotension in hypertensive patients remains unclear.

Conclusions:

  • Accurate blood pressure measurement techniques are crucial for hypertensive surgical patients.
  • Preoperative blood pressure <180/100 mmHg is generally not a reason to postpone surgery.
  • Management of higher blood pressures requires individualized, case-by-case decisions due to limited evidence.
Abstract

Keywords:
AntihypertensiveBlood pressureHypertensionPerioperative medicine

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