Blood Pressure Behavior of Hypertensive Patients According to Previous or Non-Previous Intake of Antihypertensives in Elective Non-Cardiac Surgery

Abstract

In our daily anesthesiology practice, more than half of the patients undergoing elective surgeries are known hypertensive. Despite the fact that we frequently encounter this at-risk population, in daily anesthesia practice, constant questions arise about possible hemodynamic changes. We proposed to evaluate the behavior of blood pressure (BP) in hypertensive patients according to whether or not they took antihypertensives 2 hours prior to the start of surgery. Objective: To evaluate the behavior of blood pressure in hypertensive patients according to whether or not they took antihypertensives in non-cardiac elective surgeries.

A prospective, randomized, single-blind clinical study was conducted on 100 patients with a history of essential arterial hypertension (HTA), undergoing elective surgical interventions, under general or standardized regional anesthesia. They were divided into 2 groups: group 1 that took antihypertensives 2 hours prior to entering the operating room and group 2 that did not. Study approved by the nosocomial training and teaching committee and CIEIS.

The distribution of patients according to anthropometric variables of both groups was homogeneous for the analysis. The behavior of blood pressure upon admission to the operating room of patients in group 1 showed that 66% had normal BP (< 140/90 mmHg) and 34% had HBP (BP > or = 140/90 mmHg). As for group 2, 100% were admitted with HBP (BP > or = 140/90 mmHg). In the post-anesthetic induction, this last group had a higher rate of severe hypotension and in the postoperative period a greater tendency to hypertension. All these findings were significant.

Patients who were not medicated 2 hours prior to entering the operating room have a greater tendency to be admitted with HBP and a higher rate of hemodynamic instability compared to those who were. These findings correlate with the majority of those studies referred to in the literature. In summary, antihypertensive medication 2 hours prior to the anesthetic procedure would allow admission to the operating room with normal blood pressure and greater hemodynamic stability.