43
Patients Undergoing Surgical Procedures
Preoperative
I B-NR In patients with hypertension undergoing major surgery who
have been on beta blockers chronically, beta blockers should be
continued.
IIa C-EO In patients with hypertension undergoing planned elective
major surgery, it is reasonable to continue medical therapy for
hypertension until surgery.
IIb B-NR In patients with hypertension undergoing major surgery,
discontinuation of ACE inhibitors or ARBs perioperatively may
be considered.
IIb C-LD In patients with planned elective major surgery and SBP of 180
mm Hg or higher or DBP of 110 mm Hg or higher, deferring
surgery may be considered.
III:
Harm
B-NR For patients undergoing surgery, abrupt preoperative
discontinuation of beta blockers or clonidine is potentially
harmful.
III:
Harm
B-NR Beta blockers should NOT be started on the day of surgery in
beta blocker-naïve patients.
Intraoperative
I C-EO Patients with intraoperative hypertension should be managed
with intravenous medications (Table 14) until such time as oral
medications can be resumed.
Other Comorbidities (cont'd)
COR LOE
Recommendations
