This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Ralph T. Geer, MD; D. Eric Greenhow, MD
University of Pennsylvania School of Medicine Philadelphia

JAMA. 1975;234(12):1221-1222.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent article by Perlroth and Hultgren (232:1279, 1975) is a thoughtful summary of the problems faced in the care of the cardiac patient during the perioperative period. However, we take issue with one point. They recommend discontinuing the use of antihypertensive medication in the "usual hypertensive patient" two weeks prior to surgery. This idea is an unfortunate relic from the time when neither the pharmacology of antihypertensives nor their interaction with anesthetics was well understood. Despite data to the contrary,¹ at least one well-known cardiology text supports routine discontinuance of the use of antihypertensive agents for as long as two weeks prior to surgery.² We believe this view is unwarranted. Untreated hypertensives and those poorly controlled have alarming and poorly tolerated swings in blood pressure during anesthesia and surgery and in the immediate postoperative period. There is an increased incidence of myocardial ischemia, significant . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?