Perioperative Hypertension: Defining At-Risk Patients and Their Management
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Hypertension is an extremely pervasive condition that affects a large percentage of the world population. Although guidelines exist for the treatment of the patient with elevated blood pressure, there remains a paucity of literature and accepted guidelines for the perioperative evaluation and care of the patient with hypertension who undergoes either cardiac or noncardiac surgery. Of particular importance is defining the patients most vulnerable to complications and the indications for immediate and rapid antihypertensive treatment and/or cancellation of surgery to reduce these risks in each of the three perioperative settings: preoperative, intraoperative, and postoperative. This review also examines the parenteral antihypertensive medications most commonly administered in the perioperative setting.
KeywordsHypertension Perioperative hypertension Preoperative hypertension Intraoperative hypertension Postoperative hypertension Stage 1 hypertension Stage 2 hypertension Hypertensive crisis Parenteral antihypertensive medication ACE inhibitor β-Adrenergic blocking agent Calcium channel blocker Arteriolar vasodilation Venodilation Reflex tachycardia Nitroprusside Nitroglycerin Enalaprilat Hydralazine Fenoldopam Esmolol Labetalol Nicardipine Clevidipine
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