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Perioperative hypertension At least 25% of hypertensive patients who undergo noncardiac surgery develop myocardial ischemia associated with the induction of anaesthesia or during the intraoperative or early post-anaesthesia period.These responses may be more obvious in patients with untreated hypertension in whom the systolic BP can increase by 90 mm Hg and heart rate by 40 beats per minute.Endothelial injury accompanies severe elevations of BP resulting in fibrinoid necrosis of the arterioles with the deposition of platelets and fibrin, and a breakdown of the normal autoregulatory function.The resulting ischemia speeds the further release of vasoactive substances completing a vicious cycle.
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However, there is a lack of agreement concerning treatment plans and appropriate therapeutic goals, making common management protocols difficult.Introduction Hypertension is the most common risk factor for perioperative cardiovascular emergencies.
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