The measurement of adult blood pressure and management of hypertension before elective surgery

Abstract

SummaryThis guideline aims to ensure that patients admitted to hospital for elective surgery are known to have blood pressures below 160 mmHg systolic and 100 mmHg diastolic in primary care. The objective for primary care is to fulfil this criterion before referral to secondary care for elective surgery. The objective for secondary care is to avoid spurious hypertensive measurements. Secondary care should not attempt to diagnose hypertension in patients who are normotensive in primary care. Patients who present to pre‐operative assessment clinics without documented primary care blood pressures should proceed to elective surgery if clinic blood pressures are below 180 mmHg systolic and 110 mmHg diastolic.

Postoperative management

“…To establish an improved precision in determining and predicting peri- (72). Areas where there is still debate on whether preoperative improvement has a beneficial impact on patient outcome include statin therapy as perioperative protection (73) and the preoperative optimization of hemoglobin levels (74).…”

Pre-Operative Blood Pressure Measurement and Management in the United Kingdom and Ireland – A Joint Guideline by the Association of Anaesthetists and the British Hypertension Society

“…The British Hypertension Society (BHS) approached the Association of Anaesthetists of Great Britain and Ireland (AAGBI) to develop a joint guideline to better manage this situation. The guidance was published in January 2016 [3].…”

Hypertension - potential effect on primary care

“…We welcome new AAGBI guidance on pre-operative blood pressure measurement and subsequent management of patients referred for further optmisation [1]. Although some sub-specialties are excluded (e.g.…”

“…Authors must follow the Guidance for Authors at wileyonlinelibrary.com/journal/anae, including completion and submission of an Author Declaration Form. patients back to primary care for further assessment if hypertension is noted in patients who have not had readings taken in primary care in the preceding 12 months [1]. This will create a further substantial increase in work for colleagues in primary care, at a time when workloads are a cause of concern within the profession [2].…”

“…The Working Party would like to thank Jeyarajah and Ahmad for their interesting observations on the issues of peri/post-operative hypertension. However, we think they have misunderstood the specific nature of the guideline, which concerns the measurement of adult blood pressure and management of hypertension before elective surgery [1].…”