Before Surgery: High Blood Pressure Matters

Take Home: High blood pressure is a common medical condition and often there are no symptoms associated with this problem. See your healthcare provider regularly to screen you for this potentially life threatening medical condition. You will not know you have high blood pressure unless your blood pressure is being measured and evaluated. Treatment of high blood pressure prior to elective surgery is important and will help you have the best outcomes during and after surgery.

What is blood pressure?

Blood pressure measurement is a combination of 2 numbers. The top number is considered the systolic number and this is the amount of pressure exerted against your blood vessels when your heart pumps. The bottom number is the diastolic number and this is considered the amount of pressure exerted against your blood vessels when your heart rests. These blood vessels deliver oxygenated blood from your heart to all of your body including kidneys, heart, brain, and muscles.

What is high blood pressure?

High blood pressure is when the pressure exerted against your blood vessel walls is high enough to cause some damage to the blood vessels or damage to the organs receiving the blood (kidney, brain, heart etc). The exact values your doctor will call “high” vary slightly based on which guidelines they are following and what other health conditions you have. Usually if you have a few blood pressure values over around 130-140 for the top number (systolic) and over 80-90 for the bottom number (diastolic) your doctor will initiate treatment.

What are the symptoms of high blood pressure?

Often this is a silent disease and you won’t know you have it until your blood pressure is measured. If you are experiencing severely high blood pressure you can experience a stroke or heart problems. Headaches, nose bleeds, dizziness, visual changes, chest pain and irregular heart beat can all be nonspecific indications of high blood pressure.

What damage can high blood pressure cause in my body?

Uncontrolled high blood pressure can damage the blood vessels in your body. This can lead to poor blood supply to important organs like your kidneys, brain and heart. Ultimately this can lead to kidney failure, stroke, heart attack or heart failure. When your heart has to pump against high pressures in your blood vessels it can enlarge. When your heart enlarges it can lead to poor heart function or irregular heart rhythms.

Mikael Häggström, CC0, via Wikimedia Commons

Why do I need to have my blood pressure under good control prior to surgery?

Anesthesia medications impair your body’s ability to maintain normal blood pressure. If you have normal blood pressures normally, your body can more easily compensate for the effect of the medications. If you have poorly controlled blood pressure normally your body may struggle to compensate for the blood pressure change with anesthesia. Poorly controlled blood pressure also results in blood vessels that are stiffer. This can result in much greater swings in blood pressure during anesthesia.

Blood pressure during surgery that is persistently much lower than your usual blood pressure can result in damage to some of your organs or put you at higher risk for heart attack or stroke during or after surgery. Blood pressure that is very high during or after surgery is less common but can also result in damage to your heart, kidneys and brain resulting in stroke, heart attack or kidney failure during or after surgery.

Will I be canceled for elective surgery if my blood pressure is high?

James-Alex Matthews, Infers Group, CC BY-SA 4.0, via Wikimedia Commons

High blood pressure effects 50% of the adult population. It is a common problem and the best case is for you to see your doctor prior to surgery and have your medical issues identified and treated prior to any elective surgery. You may arrive for surgery with high blood pressure.

Dangerously high levels may result in your surgery needing to be rescheduled. This will allow you to see a healthcare provider and get your blood pressure under control before surgery so you can have the best possible surgical outcome and a smooth recovery. Usually systolic blood pressures over 180-200 or diastolic pressures over 110 are considered dangerous, but this will depend on your health history and current symptoms and medical problems.

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