Key result
Anesthetic management of hypertension requires understanding updated BP guidelines and perioperative antihypertensive effects.
Anesthesia providers must understand the pharmacology of antihypertensive medications, particularly the risk of refractory hypotension associated with ACE inhibitors and ARBs during induction, to safely manage hypertensive patients.
May warrant review of updated BP guidelines and antihypertensives perioperatively; leaves open validation through controlled studies.
Hypertension is an important health challenge that affects millions of people across the world 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 will provide an overview of hypertension and blood pressure regulation. In addition, drugs affecting predominantly renal control of hypertension, such as diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and renin-inhibiting agents, will be 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. Antihypertensive medications and anesthetic management was evaluated. Anesthetic management of hypertensive patients requires understanding of updated blood pressure guidelines, physiology, and the perioperative implications of diuretics, ACE inhibitors, ARBs, and renin inhibitors.
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