Document Type
Article
Publication Title
Integrated Blood Pressure Control
Abstract
Introduction: Perioperative hypertension, defined as increased blood pressure around the surgery, is a known risk factor for perioperative complications, including cardiovascular events. Identifying reasons associated with hypertension in each period is of great help in preventing and better managing perioperative hypertension.
Objective: The aim of the study was to explore common etiologies of hypertension during the perioperative period (pre, intra, and post-operation) in patients who underwent noncardiac surgeries in University Health Network (UHN) hospitals, Canada, from 2015 to 2020.
Patients and methods: We retrospectively analyzed the medical records of 174 patients undergoing noncardiac surgeries who experienced perioperative hypertension. We assessed the prevalence of 10 reasons for perioperative hypertension as a whole and also each period separately according to the physicians' notes in patients' medical records. Two-way measurements ANOVA was used to determine the change of mean hypertension among patients for specific etiology.
Results: The common etiologies of perioperative hypertension were poorly controlled hypertension (21.8%), excessive fluid therapy (19.5%), excessive vasopressor (18.4%), and medication withdrawal (13.7%). Regarding each period separately, the most common reasons were poorly controlled hypertension for pre (42.9%) and intraoperative period (22.7%) and fluid overload for the postoperative period (20.1%). Poor control of hypertension showed both within-subject statistical significance for systolic and between-subject statistical significance for diastolic blood pressure.
Conclusion: Poorly controlled hypertension is the most significant etiology of perioperative hypertension in patients undergoing noncardiac surgeries. Apart from poorly controlled hypertension, as a patient-related factor, iatrogenic factors such as excessive vasopressor therapy, aggressive fluid replacement and poor management of antihypertensive medications can also cause perioperative hypertension.
DOI
10.2147/IBPC.S347395
Publication Date
3-19-2022
Keywords
hypertension, intraoperative, perioperative, postoperative, surgery
ISSN
1178-7104
Recommended Citation
Mohseni S, Behnam-Roudsari S, Tarbiat M, Shaker P, Shivaie S, Shafiee MA. Perioperative Hypertension Etiologies in Patients Undergoing Noncardiac Surgery in University Health Network Hospitals-Canada from 2015-2020. Integrated Blood Pressure Control. 2022; 15. doi: 10.2147/IBPC.S347395.
