Resistant hypertension and preoperative silent myocardial ischaemia in surgical patients.

Abstract:

:We studied 325 patients undergoing elective noncardiac surgery who had preoperative ambulatory ECG monitoring performed for a duration of 5130 h (range 8-24 h; mean 15.8 h). Sixty-four subjects (20%) had one or more episodes of ST segment depression consistent with myocardial ischaemia. Of all preoperative cardiovascular variables measured, the presence of elevated arterial pressure, despite patients being maintained on long term antihypertensive therapy, was the only factor associated significantly with the presence of preoperative silent myocardial ischaemia (P < 0.002). This correlation was confirmed when arterial hypertension was defined in four separate ways. The incidence of silent ischaemia in these patients was 33-55%. We suggest that admission arterial pressure may therefore be a useful screening test to identify patients at risk of preoperative myocardial ischaemia.

journal_name

Br J Anaesth

authors

Allman KG,Muir A,Howell SJ,Hemming AE,Sear JW,Foëx P

doi

10.1093/bja/73.5.574

subject

Has Abstract

pub_date

1994-11-01 00:00:00

pages

574-8

issue

5

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)41695-3

journal_volume

73

pub_type

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