Anesthesia Management in Hypertensive Patients

Abstract

Hypertension is a serious risk factor for cardiovascular morbidity and mortality in patients scheduled for elective surgery.

Although patients usually know their comorbidities when they apply for preoperative evaluation, the number of hypertensive patients without follow-up is too high to be ignored. Therefore, preoperative evaluation is very important. Hypertensive patients are treated with calcium channel blockers, ACE, ARB, diuretics and beta-blockers. While some of the patients are under control with a single drug, many of them are treated with combinations of antihypertensive drugs. Knowing the antihypertensives used by the patients is a guide in perioperative management. Since sudden hypotension in a hypertensive patient may affect vital organ perfusion, peroperative blood pressure values should be kept within 20% of preoperative values in order to prevent end-organ hypoperfusion.  In the perioperative period, sudden blood pressure lability can lead to hypoperfusion and end-organ damage. Therefore, the cause of peroperative cardiac complications is related to peroperative hemodynamic instability rather than peroperatively developing hypertension.

In conclusion, preoperative diagnosis of hypertensive patients and detailed preoperative evaluation of diagnosed patients are very important in terms of preventing complications that may develop peroperative and postoperatively.

Keywords: hypertension, general anesthesia