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Preoperative Evaluation of the Patient With Hypertension
Lee A. Fleisher, MD
JAMA. 2002;287:2043-2046.
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INTRODUCTION
Hypertension, one of the most common diagnoses in the US adult population, has prevalence in excess of 50% of individuals older than 65 years.1 Approximately 23 million US patients are anesthetized annually2; they commonly present for preoperative evaluation to the primary care physician, consultant, surgeon, or anesthesiologist with either diagnosed or undiagnosed hypertension. Even if a patient carries the diagnosis of hypertension and takes antihypertensive therapy, the hypertension may be poorly controlled. Additionally, long-standing hypertension may result in end-organ damage in the heart, brain, and kidneys, which might be unrecognized until the time of the preoperative evaluation. Accordingly, the preoperative evaluation is a unique opportunity to identify patients with hypertension and evaluate them for appropriateness of therapy and the presence of end-organ damage. Given the current pressures to proceed expeditiously with scheduled surgery, it is important for the physicians evaluating such patients to understand the . . . [Full Text of this Article]
Outcomes of Interest
Perioperative Cardiovascular Complications
End-Organ Damage and Perioperative Outcome
Should Preoperative Cardiac Testing Be Performed?
Treatment of Hypertension
Conclusion
Author Affiliation: Department of Anesthesiology, Joint Appointments in Biomedical Information Sciences, Medicine, and Health Policy and Management, Johns Hopkins University School of Medicine, Baltimore, Md.
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