Hypertension and Surgery Risks
Blood pressure readings fall into four categories with “normal blood pressure” being the lowest and “Stage 2 high blood pressure” being the highest. An ideal blood pressure reading for an adult is less than 120 systolic and less than 80 diastolic. A blood pressure reading above 140 systolic and 90 diastolic is considered Stage 1 hypertension which, when cannot be controlled by diet and a healthy lifestyle, may lead to having to be prescribed one or more medications by a doctor. When a hypertensive patient must undergo surgery, there are certain risks involved, with the level of risk increasing with the severity of the hypertension.
Postponement of Surgery – One of the first risks might be an outright postponement of surgery. Doctors may want to try getting the hypertension to a more controlled state before attempting surgery, causing the patient to have to suffer longer in whatever pain they might be in. Cardiovascular Catastrophe During Surgery – Patients with high blood pressure are more likely to suffer from cardiac issues. The chances of a hypertensive patient having a “cardiac event” are four times greater during surgery and for the first 30 days after surgery than for a patient with normal blood pressure. It is not uncommon for patients with a normal BP to experience a rise in blood pressure during anesthesia but for a hypertensive patient being anesthetized may cause a dramatic rise in both blood pressure and heart rate which can lead to a myocardial ischemia (a disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart). Renal Impairments and Stroke – In some cases the negative effects will occur after surgery. Some postoperative risks of hypertension are pain, renal impairments due to the narrowing of arteries to the kidneys and Cerebrovascular disease or Stroke . Cerebrovascular occlusive diseases occurs when plaque accumulates inside the carotid arteries – the large arteries in the neck that feed the brain. The condition can cause strokes. (UF Division of Vascular Surgery & Endovascular Therapy) Again, the level of risk involved depends on the severity of the hypertension in the patient. That’s why it is vital that an exhaustive preoperative workup is completed to assess possible risk factors and begin the process of trying to control the patient’s blood pressure beforehand.
Again, the level of risk involved depends on the severity of the hypertension in the patient. That’s why it is vital that an exhaustive preoperative workup is completed to assess possible risk factors and begin the process of trying to control the patient’s blood pressure beforehand.Article Sources: The surgical hypertensive patient
(www.ceaccp.oxfordjournals.org); Preoperative management of hypertension
(www.uptodate.com); Hypertensive patients and surgery
(www.offlineclinic.com); Perioperative hypertension management
(www.ncbi.nlm.nih.gov); Hypertension and Renal Artery Disease