Strategies for managing perioperative hypertension.

Hypertension is a pervasive and growing health concern. The occurrence of hypertension due to systemic vasoconstriction in patients before, during, and after surgery is not uncommon and can have serious consequences with regard to outcomes. Careful evaluation prior to surgery to identify the underlying cause of hypertension is important in selecting the best treatment option. Preoperative treatment options include oral beta-adrenergic receptor blockers, alpha2-adrenergic receptor antagonists, and in the case of hypertensive emergencies, the fast-acting parenteral agents sodium nitroprusside, the intravenous beta-adrenergic receptor blocker esmolol, and nicardipine. Therapeutic options during and after surgery include sodium nitroprusside, esmolol, and nicardipine, among others.