Department of Anesthesiology and the Intensive Care Unit, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
J Anesth. 2012 Aug;26(4):496-502. doi: 10.1007/s00540-012-1379-5. Epub 2012 Jun 15.
Pre-anesthesia hypertension (PAH) is the temporary elevation of blood pressure (BP), compared with normal ambulatory recorded BP or self-measured BP at home, in patients waiting for operation in the operating room (OR) before anesthesia induction. In general, the incidence of sustained hypertension (SH) increases progressively with age and the increase is greater in males than in females. In this study, we investigated the influence of age and sex on PAH.
Sampling data on consecutive patients who were more than 20 years old and who had undergone surgery under general, intrathecal, or epidural anesthesia were retrospectively collected from hospital records and anesthesia records. Patients with SH, which was defined as a past history of hypertension and taking oral antihypertensive medications, were excluded from the analyses, and the data of 231 patients, 102 males and 129 females, were used for the analyses.
The proportions of male and female patients with a systolic BP (sBP) of more than 140 mmHg in the OR before anesthesia induction were 55.9 and 42.6%, respectively. The proportions of male and female patients with a diastolic BP (dBP) of more than 90 mmHg were 34.3 and 23.3%, respectively. There was no difference in the proportions of male and female patients with PAH. The differences in sBP between measurements in the hospital room (HR) before the operation and those in the OR (ΔsBP) in males and females were 22.9 ± 25.6 and 19.0 ± 24.0 mmHg, respectively. The differences in dBP between measurements in the HR and those in the OR (ΔdBP) in males and females were 12.7 ± 16.5 and 8.4 ± 17.9 mmHg, respectively. There were no differences in ΔsBP and ΔdBP between males and females. The sBP in the OR and the ΔsBP increased significantly with age in both males and females.
Age is an important clinical factor related to PAH. Pre-anesthesia sBP and the change in pre-anesthesia sBP increase progressively with age regardless of sex. These findings suggest that the higher BP seen in the elderly in the OR before anesthesia induction, as reported previously, might be explained in part by a greater impact of PAH in older people.
术前高血压（PAH）是指在患者进入手术室（OR）等待麻醉诱导前，与正常门诊记录的血压或家庭自测血压相比，血压暂时升高。一般来说，持续性高血压（SH）的发生率随年龄增长而逐渐增加，且男性的增幅大于女性。在这项研究中，我们研究了年龄和性别对 PAH 的影响。
从医院病历和麻醉记录中回顾性收集了连续接受全身麻醉、椎管内麻醉或硬膜外麻醉的年龄超过 20 岁的患者的抽样数据。将患有 SH（即高血压病史和服用口服降压药物）的患者排除在分析之外，共纳入 231 例患者，其中男性 102 例，女性 129 例。
在麻醉诱导前 OR 中，收缩压（sBP）超过 140mmHg 的男性和女性患者比例分别为 55.9%和 42.6%。舒张压（dBP）超过 90mmHg 的男性和女性患者比例分别为 34.3%和 23.3%。PAH 患者中男性和女性的比例没有差异。与术前病房（HR）测量相比，男性和女性在 OR 中的 sBP 差值（ΔsBP）分别为 22.9±25.6mmHg 和 19.0±24.0mmHg。与 HR 相比，男性和女性在 OR 中的 dBP 差值（ΔdBP）分别为 12.7±16.5mmHg 和 8.4±17.9mmHg。男性和女性的ΔsBP 和ΔdBP 没有差异。男性和女性的 OR 中 sBP 和ΔsBP 均随年龄显著增加。
年龄是与 PAH 相关的重要临床因素。无论性别如何，麻醉前 sBP 和麻醉前 sBP 的变化均随年龄增长而逐渐增加。这些发现表明，先前报道的麻醉前 OR 中老年人较高的血压部分可能是由于老年人 PAH 的影响更大所致。
