Postoperative Hypertension

Consider the following four factors in the management of hypertension: etiology, LV function, renal function, age. In most cases, restart the preoperative antihypertensive medications unless there have been postoperative changes in LV and/or renal function.

Table 40.2 summarizes current treatment of patients with postoperative hypertension at TGH.

All postoperative patients with a Type A or B dissection, take beta-blockers, regardless of age, unless otherwise contraindicated.

Carefully evaluate the use of ACE inhibitor, if BUN and creatinine are not within normal limits.

Table 40.2. Management of postoperative hypertension

For patients < 65 years of age: Left Ventricular function

Renal Function

good

ß-blockers

Calcium channel blockers ACE inhibitors ACE inhibitors Amlodipine

Hydralazine and nitrates p-blockers

Calcium channel blockers Nitrates and hydralazine Hydralazine Nitropaste good poor

For patients > 65 years of age: Left Ventricular function

ß-blockers

Calcium channel blockers ACE inhibitors ACE inhibitors Amlodipine

Hydralazine and nitrates p-blockers

Calcium channel blockers Nitrates and hydralazine Hydralazine Nitropaste

Renal Function

For patients > 65 years of age: Left Ventricular function

Renal Function

good

poor

good

Calcium channel blockers

Calcium channel blockers

ACE inhibitors

hydralazine

Nitrates

poor

ACE inhibitors

Hydralazine

Amlodipine

Nitropaste

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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