Isolated systolic hypertension and anaesthesia

Al-Khalid, M.

doi:10.1046/j.1365-2044.2000.01798-16.x

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…In general it is accepted that hypertension is associated with increased operative risk 14 . Ideal medical control of hypertension may take weeks to months to achieve.…”

Section: Anaesthesia and Hypertensionmentioning

confidence: 99%

“…Recent data from large clinical trials 3,4 have supported data from large observational studies [5][6][7][8][9][10][11] showing a closer association of systolic hypertension with both coronary heart disease and stroke compared with diastolic hypertension This has led to a shift to recommendations for the more aggressive treatment of isolated systolic hypertension, especially in patients over 65 years 8,12,13 . It has also been suggested that anaesthetic assessment and approach should be studied and perhaps revised, in light of these developments 14,15 . This review examines the pathophysiology of isolated systolic hypertension as well as the medical and anaesthetic evidence for P. WONGPRASARTSUK, J. W. SEAR Anaesthesia and Intensive Care, Vol.…”

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confidence: 99%

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Anaesthesia and Isolated Systolic Hypertension— Pathophysiology and Anaesthesia Risk

Wongprasartsuk

Sear

2003

Anaesth Intensive Care

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This review examines the pathophysiology of isolated systolic hypertension, changing medical perspectives on this condition as a cardiovascular risk factor in the community and evolving evidence of it being an independent risk factor for perioperative morbidity and mortality.Hypertension is regarded as an added risk in anaesthesia. Continuation of antihypertensive medication through the perioperative period is an established principle. Studies supporting this practice have demonstrated greater perioperative haemodynamic stability in association with general anaesthesia and surgery in patients with treated hypertension compared to untreated hypertension. Therapy has historically focused on control of diastolic blood pressure, rather than systolic blood pressure. Recent clinical trial data and data from large observational studies show a closer association of systolic hypertension with both coronary heart disease and stroke compared with diastolic hypertension. This has led to recommendations for aggressive treatment of isolated systolic hypertension, especially in patients over 65 years old.The association between decreased compliance of the central systemic arteries and isolated systolic hypertension is well understood. The fact that this same pathology, lack of compliance of central arteries, can cause a decrease in diastolic blood pressure is not so well recognised. This means that, in patients with isolated systolic hypertension, decreasing diastolic blood pressure can be associated with worsening arterial disease and that systolic minus diastolic blood pressure may give a better indication of the problem.Anaesthetic assessment and technique should be studied and potentially revised in the light of these changes in perspective on isolated systolic hypertension.

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“…In general it is accepted that hypertension is associated with increased operative risk 14 . Ideal medical control of hypertension may take weeks to months to achieve.…”

Section: Anaesthesia and Hypertensionmentioning

confidence: 99%

mentioning

confidence: 99%

Anaesthesia and Isolated Systolic Hypertension— Pathophysiology and Anaesthesia Risk

Wongprasartsuk

Sear

2003

Anaesth Intensive Care

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“…Three recent publications have highlighted the importance of isolated systolic hypertension (ISH), and of systolic and pulse pressure as independent predictors of cardiovascular risk especially in the elderly [12–14]. Al‐Khalid raised the question in correspondence in this journal [15] as to whether anaesthesia and surgery should be delayed in patients with ISH. Neither the problem nor its solution in relation to anaesthesia is new.…”

Section: Isolated Systolic Hypertensionmentioning

confidence: 99%

Isolated systolic hypertension: pressure on the anaesthetist?

Prys‐Roberts

2001

Anaesthesia

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Isolated systolic hypertension and anaesthesia

Cited by 2 publications

References 4 publications

Anaesthesia and Isolated Systolic Hypertension— Pathophysiology and Anaesthesia Risk

Anaesthesia and Isolated Systolic Hypertension— Pathophysiology and Anaesthesia Risk

Isolated systolic hypertension: pressure on the anaesthetist?

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