Perioperative hypertension

Abstract

The effects of hypertension on the outcomes during the perioperative period are still unclear. No specific systolic or diastolic blood pressure measurement has been determined as the cutoff point to continue with the surgical plan or adjourn.This study is designed as a narrative review of the available scientific evidence on the perioperative management of hypertension. A non-systematic review was conducted in Pubmed considering the title and abstract; 120 articles were pre-selected of which 55 papers were selected for full-text eligibility and 16 were excluded for a total of 39 articles including  ACCF/AHA 2009 and ACC/AHA 2014 on perioperative cardiovascular care; 2013 ESH/ESC, 8 JNC, and the 2017 ACC/AHA/AAPA/ABC Guideline for the Prevention, detection, and management of hypertension in adults. Blood pressure values, target organ damage, and type of surgery should be considered for decision-making in the perioperative period. If surgery is an option, blood pressure fluctuations should be avoided and actively treat any potential causes. A patient with mild hypertension with values below SBP 160 and DBP 110 mmHg may be managed in the ambulatory setting during the postoperative period, as long as the clinical conditions are favorable.