Key result
Current evidence suggests that stage 1 or 2 hypertension alone is not an independent risk factor for peri-operative cardiac complications.
Why the study?
Does elevated pre-operative blood pressure increase peri-operative risk and warrant cancellation of surgery in hypertensive patients?
Does elevated pre-operative blood pressure increase peri-operative risk and warrant cancellation of surgery in hypertensive patients?
Elective surgery should not be cancelled solely for stage 1 or 2 hypertension without target organ damage, but stage 3 or 4 hypertension may warrant delay for investigation and treatment.
Does not support cancelling elective surgery for stage 1-2 hypertension; leaves open need for prospective data on severe cases.
The difficulty that anaesthetists face is that they often, when seeing a patient pre-operatively, do not have the benefit of seeing the patient’s “normal average” blood pressure taken at different times over a period of weeks. The decision to cancel surgery based on the blood pressure found at the pre-operative visit must, therefore, take into account the urgency of the surgery, as well as the presence of end organ damage from chronic hypertension. A detailed history and examination should be performed looking for evidence of coronary artery disease, cerebrovascular disease and renal dysfunction.
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D. Lines (2014) conducted a review in Hypertension. Current evidence suggests that stage 1 or 2 hypertension alone is not an independent risk factor for peri-operative cardiac complications.
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