Advertisement

Hypertension

  • Tiffany ChenEmail author
Chapter

Abstract

Hypertension is commonly encountered in the preoperative evaluation. It is associated with intraoperative blood pressure lability and the risk of myocardial ischemia. Additionally, the risk of major perioperative cardiac events increases when patients have hypertension-related end-organ damage, such as congestive heart failure or renal impairment. Preoperative evaluation to assess risk and thoughtful perioperative medication management can help avoid unnecessary surgical cancellations for uncontrolled hypertension and optimize perioperative blood pressure control.

Keywords

Perioperative Hypertension Blood pressure 

Notes

Acknowledgments

G. Alec Rooke, MD, Professor, Department of Anesthesiology and Pain Medicine, University of Washington.

References

  1. 1.
    Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;8:1043–9.CrossRefGoogle Scholar
  2. 2.
    Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130(24):2215–45.CrossRefGoogle Scholar
  3. 3.
    Howell SJ, Sear JW, Foex P. Hypertension, hypertensive heart disease and perioperative risk. Br J Anaesth. 2004;92(4):570–82.CrossRefGoogle Scholar
  4. 4.
    Hartle A, McCormack T, Carlisle J, et al. The measurement of adult blood pressure and management of hypertension before elective surgery: joint guidelines from the Association of Anaesthetists of Great Britain and Ireland and the British Hypertension Society. Anaesthesia 2016;71:326–337. Open image in new windowCrossRefGoogle Scholar
  5. 5.
    Nadella V, Howell SJ. Hypertension: pathophysiology and perioperative implications. BJA Education. 2015;15(6):275–9.CrossRefGoogle Scholar
  6. 6.
    Weksler N, Klein M, Szendro G, et al. The dilemma of immediate preoperative hypertension: to treat and operate, or to postpone surgery? J Clin Anesth 2003;15:179–183. Open image in new windowCrossRefGoogle Scholar
  7. 7.
    Monk TG, Bronsert MR, Henderson WG, et al. Association between intraoperative hypotension and hypertension and 30 day postoperative mortality in noncardiac surgery. Anesthesiology. 2015;123(2):307–19.CrossRefGoogle Scholar
  8. 8.
    Rosenman DJ, McDonald FS, Ebbert JO, et al. Clinical consequences of withholding versus administering renin-angiotensin-aldosterone system antagonists in the perioperative period. J Hosp Med. 2008;3(4):319–25.CrossRefGoogle Scholar
  9. 9.
    Roshanov PS, Rochwerg B, Patel A, et al. Withholding versus continuing antiogensin-converting enzyme inhibitors or angiotensin II receptor blockers before noncardiac surgery: an analysis of the vascular events in noncardiac surgery patients cohort evaluation prospective cohort. Anesthesiology. 2017;126(1):16–27.CrossRefGoogle Scholar
  10. 10.
    Hollman C, Fernandes NL, Biccard BM. A systematic review of outcomes associated with withholding or continuing angiotensin-converting enzyme inhibitors and angiotensive receptor blockers before noncardiac surgery. Anesth Analg. 2018;127:678.CrossRefGoogle Scholar
  11. 11.
    Kristensen SD, Knuuti J, Saraste A, et al. 2014 ESC/ESA guidelines on non-cardiac surgery: cardiovascular assessment and management: the joint task force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35(35):2383–431.CrossRefGoogle Scholar
  12. 12.
    Khan NA, Campbell NR, Frost SD, et al. Risk of intraoperative hypotension with loop diuretics: a randomized control trial. Am J Med. 2010;123:1059e1–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Medicine, Division of General Internal MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations