Key result
Untreated hypertension is linked to greater postinduction MAP drops than treated hypertension or normotension.
Why the study?
Does untreated hypertension increase blood pressure lability during general anesthesia induction in adults undergoing elective surgery?
Cohort (n=341)
Does untreated hypertension increase blood pressure lability during general anesthesia induction in adults undergoing elective surgery?
p-value: p=< 0.0001
This study emphasizes that untreated hypertension is associated with significant blood pressure lability during the induction of general anesthesia, underscoring the importance of adequate preoperative blood pressure control.
Untreated hypertension may heighten induction hypotension risk; leaves open whether preoperative control modifies outcomes in elective surgery.
Objectives: This study aimed to verify the relationship between blood pressure (BP) obtained during preoperative evaluation at preinduction and compared to BP at 20 min after induction for normotensive and hypertensive patients. Methods: Data from patients who underwent elective surgical procedures from July 2018 to September 2019 were retrospectively extracted and analyzed. The data included patient characteristics (age, sex, weight, height, body mass index (BMI)), physical status (ASA classification), comorbidities, medications in use, and mean arterial BP (MAP) recorded preoperatively (MAPpre-op), before induction of anesthesia (MAPpre-ind), and 20 min after induction (MAPpost-ind). Results: A total of 1026 patients were selected, 341 were included in the final analysis (normotensive patients (GNT n = 203), treated hypertensive patients (GTREAT n = 98), untreated hypertensive patients (GNO TREAT n = 40). There was an increase in the median MAP from preoperation to preinduction in the total sample and the three groups (GNT, GTREAT, and GNO TREAT). There was a statistically significant reduction in MAPpost-ind concerning MAPpre-ind and MAPpre-op in the three groups. The three groups’ comparison showed a statistically significant difference between MAPpost-ind and MAPpre-ind and between MAPpost-ind and MAPpre-op. Conclusions: Our study showed that normotensive and hypertensive patients showed a significant BP increase at the preinduction time point. Treated and untreated hypertensive patients had a more considerable increase in preinduction BP and BP reduction at 20 min after anesthesia induction than normotensive patients. These changes were more significant in hypertensive patients without treatment.
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De et al. (2020) conducted a cohort in Patients undergoing elective surgery under general anesthesia (n=341). Hypertension (treated and untreated) vs. Normotensive patients was evaluated on Difference between mean arterial pressure (MAP) 20 minutes postinduction and MAP preinduction (p=< 0.0001). Untreated hypertensive patients had a significantly greater reduction in mean arterial pressure at 20 minutes postinduction compared to normotensive and treated hypertensive patients.
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