Control of hypertension following carotid endarterectomy.

The role of carotid endarterectomy in the treatment of extracranial carotid artery disease has been well established. Postoperative hypertension is a significant prognostic factor and is associated with an increased incidence of both transient and permanent neurologic deficits. We studied 110 patients undergoing unilateral carotid endarterectomy to review the efficacy of the drug combination of hydralazine and propranolol to treat postoperative hypertension. All patients receiving hydralazine and propranolol had their blood pressure controlled postoperatively, and no patients developed hypotension, myocardial infarction, or postoperative neurologic deficits. There were no mortalities in the study group. We conclude that propranolol-hydralazine therapy is a safe and effective means to control hypertension associated with carotid endarterectomy.