Key result
Optimal perioperative hypertension management involves continuing antihypertensives until surgery morning and maintaining BP below 160/90.
Why the study?
How should hypertension be managed perioperatively in surgical patients?
How should hypertension be managed perioperatively in surgical patients?
Provides practical recommendations for the perioperative management of hypertension in surgical patients.
May guide perioperative BP management in surgical patients; leaves open need for randomized validation of targets.
Questions concerning the proper management of hypertension in surgical patients often arise in primary care practice. Currently available literature and our own clinical experience lead us to make the following recommendations. 1. Continue antihypertensive therapy up to and including the morning of surgery, when the dose should be given with a small sip of water. 2. If possible, adjust antihypertensive therapy so blood pressure is less than 160/90 mm Hg for at least two weeks prior to surgery. 3. Discontinue all monoamine oxidase inhibitors at least one week prior to surgery and substitute alternative antihypertensive or antidepressant medication as necessary. 4. Be attentive to the patient's preoperative volume status and any evidence of cardiovascular disease. 5. In patients with postoperative hypertension, search for specific aggravating factors and treat them primarily. 6. Discuss with the anesthesiologist any difficulties in blood pressure control.
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Thompson et al. (1988) conducted a review in Perioperative hypertension. Perioperative hypertension management was evaluated. Proper management of perioperative hypertension includes continuing antihypertensive therapy up to the morning of surgery and maintaining blood pressure below 160/90 mm Hg preoperatively.
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