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The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity
Hypertension is not consistently associated with postoperative cardiovascular morbidity and therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with perioperative morbidity and mortality, such...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2020
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| _version_ | 1867613222488506368 |
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| access_status_str | Open Access |
| author | Crowther, Marcelle |
| author2 | Roodt, Francois |
| author_browse | Crowther, Marcelle Roodt, Francois |
| author_facet | Roodt, Francois Crowther, Marcelle |
| author_sort | Crowther, Marcelle |
| collection | Thesis |
| description | Hypertension is not consistently associated with postoperative cardiovascular morbidity and therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with perioperative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes. We performed a five-day multicentre, prospective, observational cohort study which included all adult inpatients undergoing elective, noncardiac, non-obstetric surgery. We recruited 343 patients of whom 164 (47.8%) were hypertensive. An intra-operative mean arterial pressure of 100 beats per minute) occurred in 126 (38.9%) patients, of which 61 (48.4%) were hypertensive. Multivariable logistic regression did not show an independent association between the stage of hypertension and either clinically significant hypotension or tachycardia, when controlled for ASA physical status, functional status, major surgery, the duration of surgery or blood transfusion. There was no association between pre-operative hypertension and peri-operative haemodynamic changes known to be associated with major morbidity and mortality. These data therefore support the recommendation of the Joint Guidelines of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society to proceed with elective surgery if a patient’s blood pressure is < 180/110 mmHg. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31496 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:42.829Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31496 The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity Crowther, Marcelle Roodt, Francois Biccard, Bruce Pre-operative hypertension intra-operative hypotension peri-operative morbidity and mortality Hypertension is not consistently associated with postoperative cardiovascular morbidity and therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with perioperative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes. We performed a five-day multicentre, prospective, observational cohort study which included all adult inpatients undergoing elective, noncardiac, non-obstetric surgery. We recruited 343 patients of whom 164 (47.8%) were hypertensive. An intra-operative mean arterial pressure of 100 beats per minute) occurred in 126 (38.9%) patients, of which 61 (48.4%) were hypertensive. Multivariable logistic regression did not show an independent association between the stage of hypertension and either clinically significant hypotension or tachycardia, when controlled for ASA physical status, functional status, major surgery, the duration of surgery or blood transfusion. There was no association between pre-operative hypertension and peri-operative haemodynamic changes known to be associated with major morbidity and mortality. These data therefore support the recommendation of the Joint Guidelines of the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the British Hypertension Society to proceed with elective surgery if a patient’s blood pressure is < 180/110 mmHg. 2020-03-06T09:43:12Z 2020-03-06T09:43:12Z 2019 2020-03-05T07:06:07Z Master Thesis Masters MMed http://hdl.handle.net/11427/31496 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Pre-operative hypertension intra-operative hypotension peri-operative morbidity and mortality Crowther, Marcelle The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| thesis_degree_str | Master's |
| title | The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| title_full | The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| title_fullStr | The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| title_full_unstemmed | The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| title_short | The relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| title_sort | relationship between preoperative hypertension and intraoperative haemodynamic changes known to be associated with postoperative morbidity |
| topic | Pre-operative hypertension intra-operative hypotension peri-operative morbidity and mortality |
| url | http://hdl.handle.net/11427/31496 |
| work_keys_str_mv | AT crowthermarcelle therelationshipbetweenpreoperativehypertensionandintraoperativehaemodynamicchangesknowntobeassociatedwithpostoperativemorbidity AT crowthermarcelle relationshipbetweenpreoperativehypertensionandintraoperativehaemodynamicchangesknowntobeassociatedwithpostoperativemorbidity |