围手术期高血压与心血管风险

Perioperative Hypertension and Cardiovascular Risk

在围手术期,高血压患者与血压正常患者相比,存在较高的心血管风险。这些患者更容易发生围手术期心肌的局部缺血、心律失常和心血管的不稳定。目前,还没有明确的证据表明延期麻醉和手术能够减少这些患者围手术期的心血管风险。但对于合并有靶器官损害的重度高血压患者,推迟手术以获得对血压的有效控制可能是合理的。通过适当的评估和有效的处理,有望降低高血压患者围手术期的心血管风险和远期预后。

Hypertensive patients have a more vigorous perioperative cardiovascular risk than Normotensives. Such patients are more prone to perioperative ischaemia, arrhythmias, and cardiovascular lability. There is no clear evidence that deferring anaesthesia and surgery in such patients reduces perioperative risk. But delaying surgery until better blood pressure control is obtained in severe hypertensive patients may be justified if target organ damage exists. Appropriate evaluation and intervention can be expected to decrease cardiovascular risk and improve long-term outcome.