Is blood pressure control necessary before surgery?

The need for blood pressure control before elective surgery depends on the degree and type of hypertension and the presence of other cardiovascular risk factors. Although blood pressure should be normalized in most patients for several months before surgery, mild to moderate diastolic or systolic hypertension do not place the patient at increased operative risk. Mild to moderate elevations should not be acutely controlled in the few days before surgery. Higher blood pressure elevations confer an increased operative risk and must be carefully controlled before surgery. Blood pressure control with certain antihypertensive medications confers a protective effect on the risk of intraoperative instability. The impact of preoperative control of hypertension in relationship to these variables is incorporated into useful recommendations for clinical practice.