Key result
Perioperative anesthetic management of hypertensive patients requires careful blood pressure control and continuation of most antihypertensive medications, particularly beta-blockers and alpha-2 agonists, to prevent rebound hypertension.
This review provides a comprehensive overview of antihypertensive medications and their anesthetic implications, emphasizing the importance of continuing most antihypertensives, particularly beta-blockers, perioperatively to avoid rebound hypertension.
May guide individualized perioperative antihypertensive management; leaves open need for prospective trials on agent-specific outcomes.
Hypertension is an important health challenge that affects millions of people across the world today and is a major risk factor for cardiovascular disease. It is critical that anesthesia providers have a working knowledge of the systemic implications of hypertension. This review article will discuss the medical definitions of hypertension, the physiology of maintaining blood pressure, outpatient treatment of hypertension, anesthetic implications, and the common medications used by anesthesia providers in the treatment of hypertension. Part I provided an overview of hypertension and blood pressure regulation. In addition, drugs predominantly affecting control of hypertension via renal mechanisms such as diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and renin-inhibiting agents were discussed. In part II, the remaining major antihypertensive medications will be reviewed as well as anesthetic implications of managing patients with hypertension.
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Russell Yancey (2018) conducted a review in Hypertension. Perioperative anesthetic management was evaluated. Perioperative anesthetic management of hypertensive patients requires careful blood pressure control and continuation of most antihypertensive medications, particularly beta-blockers and alpha-2 agonists, to prevent rebound hypertension.
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