Highlights the ongoing uncertainty and clinical challenge of managing uncontrolled hypertension in the perioperative setting.
The textbook (Churchill-Davidson, 1978) that I used for the FFARCS diploma, now the FRCA, was unequivocal: ‘The hypertensive patient represents an increased risk for anaesthesia and surgery.’ The opening paragraph of the section went on to speak of cerebrovascular accidents, myocardial infarction, and all manner of mischief. As with so much in medicine, the intervening years have seen certainty replaced by uncertainty, although uncontrolled or poorly controlled hypertension is still one of the main medical reasons that operations are cancelled on the day of surgery.
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Neville W. Goodman (2005) studied this question.
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