Hypertension remains one of the most common avoidable medical indications for deferring elective surgery, thereby increasing both the financial and emotional burden of having an operation. Although the evidence supporting the current guidelines on management of hypertension is among the best available in any field of medicine, our knowledge on whether high blood pressure (BP) is an independent perioperative risk factor is plagued by much uncertainty. Indeed, it is still unclear whether postponing surgery on the ground of elevated preoperative BP measurements will lead to a reduction in perioperative cardiac risk. Similarly, the importance of multiple versus isolated BP measurements in predicting perioperative complications has not yet been assessed. As most studies have evaluated the predictive value of diastolic BP, the risk of perioperative cardiovascular events associated with isolated systolic hypertension remains uncertain. With no controlled evidence to address these issues, no firm recommendations can be made to improve patients' safety. These important issues now need to be addressed by modern clinical trials.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.