Key result
Patients with mild hypertension (SBP <160 and DBP <110 mmHg) may be managed in the ambulatory setting during the postoperative period, provided clinical conditions are favorable.
Why the study?
The effects of hypertension on perioperative outcomes remain unclear, and no specific blood pressure cutoff has been established to guide decisions to proceed with or adjourn surgery.
This narrative review highlights that perioperative hypertension management should consider blood pressure values, target organ damage, and surgery type, and that mild hypertension (SBP <160, DBP <110 mmHg) does not necessitate delaying surgery.
May support ambulatory postoperative care for mild hypertension when stable; leaves open need for prospective trials.
The effects of hypertension on the outcomes during the perioperative period are still unclear. No specific systolic or diastolic blood pressure measurement has been determined as the cutoff point to continue with the surgical plan or adjourn.This study is designed as a narrative review of the available scientific evidence on the perioperative management of hypertension. A non-systematic review was conducted in Pubmed considering the title and abstract; 120 articles were pre-selected of which 55 papers were selected for full-text eligibility and 16 were excluded for a total of 39 articles including ACCF/AHA 2009 and ACC/AHA 2014 on perioperative cardiovascular care; 2013 ESH/ESC, 8 JNC, and the 2017 ACC/AHA/AAPA/ABC Guideline for the Prevention, detection, and management of hypertension in adults. Blood pressure values, target organ damage, and type of surgery should be considered for decision-making in the perioperative period. If surgery is an option, blood pressure fluctuations should be avoided and actively treat any potential causes. A patient with mild hypertension with values below SBP 160 and DBP 110 mmHg may be managed in the ambulatory setting during the postoperative period, as long as the clinical conditions are favorable.
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León et al. (2023) conducted a review in Perioperative hypertension. Perioperative blood pressure management was evaluated. Patients with mild hypertension (SBP <160 and DBP <110 mmHg) may be managed in the ambulatory setting during the postoperative period, provided clinical conditions are favorable.
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