Systemic hypertension associated with coronary artery bypass surgery

Roberts, Arthur J.; Niarchos, Andreas P.; Subramanian, Valavanur A.; Abel, Ronald M.; Herman, Steven D.; Sealey, Jean E.; Case, David B.; White, Robert P.; Johnson, George; Laragh, John H.; Gay, William A.; Okinaka, Arthur J.

doi:10.1016/s0022-5223(19)41183-5

Cited by 157 publications

(16 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, different opinions exist as to whether the renin-angiotensin system plays a major role for hypertensive reactions during surgery and in the early postoperative period after CABG (4). Roberts et al studied systemic hypertension associated with coronary artery bypass surgery and found a positive correlation between the changes in plasma renin activity and mean arterial pressure in hypertensive patients (23). Another study showed marked elevation of angiotensin I1 plasma levels during and for several hours after CPB.…”

Section: Discussionmentioning

confidence: 98%

The effect of i. v. enalaprilat in chronically treated hypertensive patients during cardiac surgery

Schuetz

Lindner

Georgieff

et al. 1998

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 98%

The effect of i. v. enalaprilat in chronically treated hypertensive patients during cardiac surgery

Schuetz

Lindner

Georgieff

et al. 1998

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Numerous studies have identified the principal mediators of postoperative hypertensive episodes and confirmed the relationships (9). In general, elevated levels of catecholamines, both adrenaline (epinephrine) and noradrenaline (norepinephrine), have been documented (3, 13).…”

Section: Haemodynamic Alterationsmentioning

confidence: 96%

“…Other potential predisposing factors include hypothermia, elevated plasma renin and angiotensin levels (3, 9,27), elevated plasma adrenaline and noradrenaline levels (3, 12, 28), or pressor reflexes originating from the heart, great vessels or coronary arteries (12, 29,30).…”

Section: Predictors Of Hypertensionmentioning

confidence: 99%

Incidence and aetiology of perioperative hypertension

Leslie

1993

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

The reported incidence of perioperative hypertension associated with coronary artery bypass-graft (CABG) surgery ranges from 3(HKP/o, which may reflect the various definitions of the condition as well as differences in the patients' preoperative states. Systolic, diastolic and mean arterial blood pressures are variously used to define perioperative hypertension, but absolute values range from a target systolic blood pressure of below 170 mmHg in some studies to below 110 mmHg in others. Patients' preoperative states have been extensively studied to determine potential risk factors. The majority of these studies indicate that perioperative hypertension is predictive of perioperative cardiac morbidity, but others do not confirm this finding, rendering the issue unresolved. The consequences of perioperative hypertensive episodes include bleeding from vascular suture lines, cerebrovascular haemorrhage or subendocardial ischaemia, and are associated with a mortality rate that may approach 50%. Increases in peripheral vascular resistance (PVR), caused by elevated levels of circulating catecholamines, appear to be the primary aetiology. Antihypertensive agents which correct or prevent the increase in PVR would appear to be the most appropriate therapy. However, no single agent appears to be ideal for all hypertensive episodes, suggesting multiple potential aetiologies.

show abstract

“…Cardiopulmonary bypass is a potent stimulus of reninangiotensin activation and has been implicated in the development of postoperative hypertension. The rise in plasma renin activity seen intra-operatively persists for many hours into the postoperative period [77][78][79] and may not be associated with a rise in plasma catecholamine concentrations [77]. In one early study comparing reninangiotensin system activation in patients undergoing closed mitral valvotomy or open-heart procedures using cardiopulmonary bypass [80], plasma renin activity and plasma angiotensin I1 concentrations rose substantially only in those patients who underwent cardiopulmonary bypass, and the rise began only after bypass commenced.…”

Section: The Renin-angiotensin System During Anaesthesia and Surgerymentioning

confidence: 99%