Table of ContentsView AllTable of ContentsPrior to SurgeryDuring SurgeryAfter SurgeryFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Prior to Surgery
During Surgery
After Surgery
Frequently Asked Questions
Anticipating a surgery can be an anxiety-provoking time. And if you have high blood pressure (also known ashypertension), you may have additional concerns about how you will respond to general anesthesia.
Ideally, your blood pressure will be normalized several months before your surgery. While research has found that “mild to moderate diastolic or systolic hypertension do not place the patient at increased operative risk,” high blood pressure may pose “an increased operative risk and must be carefully controlled before surgery.”
This article outlines what to expect before, during, and after a surgery if you have high blood pressure.
Verywell / Theresa Chiechi
If you have high blood pressure, surgery might put you at risk for:
In general, the risk increases as a blood pressure reading increases. This said, high blood pressure is usually not a reason to postpone surgery unless a person is undergoing an elective major surgery and blood pressure is poorly controlled. This means thesystolic blood pressureis 180 mmHg or higher or the diastolic blood pressure is 110 mmHg or higher.In this case, deferring surgery may be a good idea since a normal pressure is less than 120/80 mm Hg.
It’s essential to follow your healthcare team’s instructions on which medications to continue and which to stop prior to your surgery.
For people with chronic high blood pressure, in most instances, continuinghigh blood pressure medications(called antihypertensives) is generally safe. In fact, stopping some of them can cause a rebound effect, where blood pressure rises.
However, some high blood pressure medications (likeACE inhibitorsorangiotensin receptor blockers) are held for a certain period of time, such as 24 hours, prior to surgery.In the end, be sure toclarify with your healthcare provider precisely which medications you should and should not take before surgery. Every patient is different, and so is their medical history. Your provider should know you and your history like the back of their own hand.
Here’s How to Interpret Your Blood Pressure Chart
Just before you enter the operating room, your anesthesiologist will ask you a few questions about your medical history, in addition to doing a review of your medical chart. This way, they will be aware of your baseline blood pressure, medication allergies, and/or prior reactions to anesthesia.
To treat high blood pressure during surgery, your anesthesiologist may administer intravenous (through your vein)antihypertensives(or hypertension medicine).
On the other hand, if you lose blood during surgery, your blood pressure may drop. Fluids and/or a blood transfusion may be all you need to increase your blood pressure. But if there is a severe loss of blood during surgery (meaning, more than 20% of your body’s blood supply), a life-threatening condition calledhypovolemicshock (meaning, a drop in blood volume) may develop.
Hypovolemic shock occurs when the loss of blood makes it hard for the heart to beat properly, which in turn reduces the amount of blood that gets to major organs. This type of shock requires emergent replacement of blood to ensure your organs get the oxygen they need to function.
RecapAn anesthesiologist does much more than administer anesthesia before surgery. It’s their job to monitor your blood pressure closely and respond accordingly if it climbs too high or drops too low.
Recap
An anesthesiologist does much more than administer anesthesia before surgery. It’s their job to monitor your blood pressure closely and respond accordingly if it climbs too high or drops too low.
As you recover from anesthesia, your blood pressure and heart rate may slowly and naturally increase. If you experience markedlyhigh blood pressure after surgery(when the systolic pressure is 180 mmHg or higher), you likely will be given intravenous medications (instead of oral medications) to lower your blood pressure.
You should also know that there can be dangerous and life-threatening dips in your blood pressure after surgery due to aninfection. In order to prevent or treat a potential infection, your healthcare provider may have you take antibiotics before or after your surgery.
Summary
in general, surgical risks increase the higher your blood pressure happens to be. This said, high blood pressure is usually not a reason to postpone surgery unless you’re undergoing an elective major surgery or your blood pressure is poorly controlled. For people with chronic high blood pressure, in most instances, continuinghigh blood pressure medicationsis generally safe. In fact, stopping some of them can cause a rebound effect, where blood pressure rises. However, some high blood pressure medications (likeACE inhibitorsorangiotensin receptor blockers) are held for a certain period of time, such as 24 hours, prior to surgery.
During surgery, the anesthesiologist will keep a close and constant eye on your blood pressure, as well as other vital signs. As you recover from anesthesia after surgery, your blood pressure and heart rate may slowly and naturally increase. You should know that there can be dangerous and life-threatening dips in your blood pressure after surgery due to aninfection. In order to prevent or treat a potential infection, your healthcare provider may have you take antibiotics before or after your surgery.
In the end, be sure toclarify with your healthcare provider precisely which medications you should and should not take before surgery. Every patient is different, and so is their medical history. It follows that their pre- and post-surgical instructions will differ, too.
Frequently Asked QuestionsYes. If you have been diagnosed with hypertension, you are at increased risk of complications from surgery. Possible complications include congestive heart failure, heart attack, kidney problems, and stroke. Treating hypertension before surgery may help lower your risk.Your blood pressure is monitored continuously during surgery with asphygmomanometer(blood pressure cuff). Your anesthesiologist will monitor your blood pressure and administer IV medication as needed to regulate your blood pressure.Your blood pressure will continue to be closely monitored in the immediate aftermath of surgery. If your blood pressure becomes elevated, you will likely be given medicine through an IV to bring it down.
Yes. If you have been diagnosed with hypertension, you are at increased risk of complications from surgery. Possible complications include congestive heart failure, heart attack, kidney problems, and stroke. Treating hypertension before surgery may help lower your risk.
Your blood pressure is monitored continuously during surgery with asphygmomanometer(blood pressure cuff). Your anesthesiologist will monitor your blood pressure and administer IV medication as needed to regulate your blood pressure.
Your blood pressure will continue to be closely monitored in the immediate aftermath of surgery. If your blood pressure becomes elevated, you will likely be given medicine through an IV to bring it down.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wolfsthal SD.Is blood pressure control necessary before surgery?Med Clin North Am. 1993 Mar;77(2):349-63. doi:10.1016/s0025-7125(16)30256-5.Kheterpal S et al.Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery.Anesthesiology. 2009 Jan;110(1):58-66. doi:10.1097/ALN.0b013e318190b6dc.American College of Cardiology.2017 guideline for the prevention, detection, and management of high blood pressure in adults.UpToDate.Perioperative management of hypertension.Aronow WS.Management of hypertension in patients undergoing surgery.Ann Transl Med. 2017;5(10):227. doi:10.21037/atm.2017.03.54.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wolfsthal SD.Is blood pressure control necessary before surgery?Med Clin North Am. 1993 Mar;77(2):349-63. doi:10.1016/s0025-7125(16)30256-5.Kheterpal S et al.Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery.Anesthesiology. 2009 Jan;110(1):58-66. doi:10.1097/ALN.0b013e318190b6dc.American College of Cardiology.2017 guideline for the prevention, detection, and management of high blood pressure in adults.UpToDate.Perioperative management of hypertension.Aronow WS.Management of hypertension in patients undergoing surgery.Ann Transl Med. 2017;5(10):227. doi:10.21037/atm.2017.03.54.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wolfsthal SD.Is blood pressure control necessary before surgery?Med Clin North Am. 1993 Mar;77(2):349-63. doi:10.1016/s0025-7125(16)30256-5.Kheterpal S et al.Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery.Anesthesiology. 2009 Jan;110(1):58-66. doi:10.1097/ALN.0b013e318190b6dc.American College of Cardiology.2017 guideline for the prevention, detection, and management of high blood pressure in adults.UpToDate.Perioperative management of hypertension.Aronow WS.Management of hypertension in patients undergoing surgery.Ann Transl Med. 2017;5(10):227. doi:10.21037/atm.2017.03.54.
Wolfsthal SD.Is blood pressure control necessary before surgery?Med Clin North Am. 1993 Mar;77(2):349-63. doi:10.1016/s0025-7125(16)30256-5.
Kheterpal S et al.Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery.Anesthesiology. 2009 Jan;110(1):58-66. doi:10.1097/ALN.0b013e318190b6dc.
American College of Cardiology.2017 guideline for the prevention, detection, and management of high blood pressure in adults.
UpToDate.Perioperative management of hypertension.
Aronow WS.Management of hypertension in patients undergoing surgery.Ann Transl Med. 2017;5(10):227. doi:10.21037/atm.2017.03.54.
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