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Incidence and aetiology of perioperative hypertension

 

作者: J. B. LESLIE,  

 

期刊: Acta Anaesthesiologica Scandinavica  (WILEY Available online 1993)
卷期: Volume 37, issue 1  

页码: 5-9

 

ISSN:0001-5172

 

年代: 1993

 

DOI:10.1111/j.1399-6576.1993.tb03816.x

 

出版商: Blackwell Publishing Ltd

 

关键词: Aetiology;coronary artery bypass–grafting;incidence;perioperative hypertension

 

数据来源: WILEY

 

摘要:

The reported incidence of perioperative hypertension associated with coronary artery bypass–graft (CABG) surgery ranges from 30–80%, 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 aetiolog

 

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