Perioperative Hypertension in Elderly Patients: Predictors, Intraoperative Management, and Postoperative Complications

Abstract

Background: Perioperative hypertension is a common and critical concern in elderly patients, given its potential to lead to severe postoperative complications. The management of blood pressure during the perioperative period is essential to minimize the risks of stroke, myocardial infarction, renal dysfunction, and other adverse outcomes. Methods: The study was conducted at North Bengal Medical College Hospital from 2021 to 2023, with a total of 150 elderly patients aged 60 years and above. A prospective, observational study design was employed to evaluate the predictors of perioperative hypertension and its association with postoperative complications. Statistical analysis was performed using chi-square tests for categorical variables. A p-value of less than 0.05 was considered statistically significant. Result: The majority of patients were aged 60-65 years, with age significantly influencing perioperative hypertension (p=0.012). Preoperative hypertension was a strong predictor (p=0.000), while the use of antihypertensive and antidiabetic medications was also linked to perioperative hypertension (p=0.000 and p=0.008, respectively). Intraoperative blood pressure control was associated with improved outcomes (p=0.035). Postoperative complications, including myocardial infarction (p=0.032), renal dysfunction (p=0.010), and respiratory complications (p=0.047), were significantly more common in patients with perioperative hypertension. However, stroke and surgical site infection showed no significant association with perioperative hypertension. Conclusion: Perioperative hypertension in elderly patients is a critical concern, influenced by predictors such as pre-existing hypertension, diabetes, and cardiovascular disease.