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The relationship between pre-operative hypertension and intra-operative haemodynamic changes known to be associated with postoperative morbidity - 12/7/2018


Anaesthesia 2018; 73: 812-18

Introduction

Hypertension may predispose to perioperative haemodynamic changes known to be associated with perioperative morbidity and mortality, such as intra-operative hypotension and tachycardia. These authors aimed to determine whether preoperative hypertension was independently associated with haemodynamic changes known to be associated with adverse perioperative cardiovascular outcomes.

 

Methods


The authors performed a 5-day multicentre, prospective, observational cohort study which included all adult inpatients undergoing elective, non-cardiac, non-obstetric surgery.

 

Results


A total of 343 patients were recruited, of whom 164 (47.8%) were hypertensive. An intraoperative mean arterial pressure of <55 mmHg occurred in 59 (18.2%) patients, of whom 25 (42.4%) were hypertensive. Intraoperative tachycardia (heart rate>100 beats/min) occurred in 126 (38.9%) patients, of whom 61 (48.4%) were hypertensive. Multivariable logistic regression did not show an independent association between the stage of hypertension and either clinically significant hypotension or tachycardia, when controlled for ASA physical status, functional status, major surgery, duration of surgery or blood transfusion. There was no association between preoperative hypertension and perioperative haemodynamic changes known to be associated with major morbidity and mortality.

 

Conclusions


The authors conclude that their data support the recommendation of the Joint Guidelines of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society to proceed with elective surgery if a patient's blood pressure is <180/110 mmHg.


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ArticleDate:20180712
SiteSection: Abstracts



 
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