Veronika Pokorná, Svetlana Bodíková
Arterial hypertension is a very frequent cardiovascular disease. Arterial hypertension leads to intraoperative blood
pressure lability, thereby increasing the risk of perioperative complications. Uncontrolled arterial hypertension is
a frequent reason to defer surgery, even though there is no clear evidence of benefits from delaying surgery to optimize
therapy. Some groups of antihypertensives carry a higher risk of hypotension and bradycardia in the context of surgery,
therefore a preoperative change in treatment is needed. Treatment with betablockers can continue in the perioperative
period. Preoperative initiation of betablockers in patients with arterial hypertension but without additional risk
factors is not recommended. Discontinuation of treatment with ACEI/ARBs before surgery should be considered in hypertensive
patients with normal left ventricular systolic function. As for calcium channel blockers, short-acting dihydropyridines
should be avoided. Diuretics for hypertension should be continued to the day of surgery, keeping in mind
the possibility of electrolyte disturbance, namely hypokalemia.