Can You Have Surgery If You Have High Blood Pressure?

Having surgery can effect how high or low your blood pressure is

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Elevated blood pressure is almost never a reason to delay or cancel surgery. In some cases of secondary hypertension—high blood pressure caused by an underlying medical issue—very high blood pressure before surgery cannot be avoided. In cases like this, surgery is meant to correct the cause of the high blood pressure.

What Happens to Your Blood Pressure During Surgery

During surgery, a type of doctor called an anesthesiologist monitors your vital signs.

In addition to giving you medication, which will put you to sleep for the surgery, they also carefully watch your heart rate, breathing pattern, and blood pressure. By studying your medical history and understanding the type of surgery being performed, the anesthesiologist knows what values each vital sign should have. During the surgery, they will not only monitor these values but will use intravenous drugs to correct them should your vitals start to deviate from accepted values.

The drugs used to control heart rate and blood pressure during surgery are all given through an IV tube, are fast acting, and extremely effective. Throughout the surgical procedure, all of your vital signs will be maintained at very close to their ideal levels.

For elective surgical procedures like cosmetic surgery or vision correction surgery, the surgeon may want to try and get your blood pressure as close to normal as possible before proceeding with the surgery.

While this is not strictly necessary, it does reduce the risk of certain surgical complications. Since the surgery can safely be delayed as long as necessary, this approach is medically appropriate in these circumstances.

Changes in Blood Pressure After Surgery 

For some people, surgery can cause blood pressure to drop.

The medication used can cause your pressure to become less or side effects of your surgery can cause pressure to drop. If you lose a lot of blood, your blood pressure can drop. How much blood you lose and the effect it has on your blood pressure will determine whether or not you require a blood transfusion. If you lose a lot of blood during your procedure, your surgeon will replace the blood you've lost during surgery while you are anesthetized. Severe blood loss can lead to hypovolemic shock, which can damage your kidneys and heart. 

Infections, including sepsis, can also lower your blood pressure. Your doctor may put you on antibiotics before or after surgery to decrease your risk of getting an infection. If you get sepsis and experience septic shock, your blood pressure can become critically low. Sepsis is typically treated with antibiotics and IV fluids. Signs of sepsis may include fever, fatigue, low blood pressure and changes in your heart rate and breathing.

If you have any questions about how your blood pressure might affect your surgery, ask your anesthesiologist or surgeon. They will be able to discuss your specific case in detail and offer suggestions on how to proceed.

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