Antihypertensive management in patients before and during surgical procedure

Abstract

Hypertension is one of the most common cardiovascular diseases and concerns approximately 30% of the adult population. Among middle-aged patients near every other man and every third woman are suffering from arterial hypertension. However, neither National nor International Societies of Hypertension have prepared any proper guidelines concerning antihypertensive treatment in patients undergoing surgical procedure. The aim of this review is to summarise the current knowledge concerning the management in hypertensive patients during the perioperative period. In contrast to the previous statement we can conclude that antihypertensive treatment should be continued until the day of the surgery. The general rule is to administer antihypertensive oral drugs until the morning of the operation day to ensure proper blood pressure control during the perioperative period. According to recent data, it seems that b-adrenergic blockers should be recommended in the first place. It has been shown that these drugs not only improve blood pressure control but also successfully prevent the patient arrhythmias including tachycardia. When some contraindications for b-blockers occur before surgical procedure, long-acting calcium channel blockers should be administered.