THE IMPORTANCE OF BETA BLOCKERS AND ANGIOTENZIN CONVERTING ENZYME INHIBITORS FOR PREOPERATIVE TREATMENT IN HYPERTENSIVE PATIENTS
In order to evaluate the effects of antihypertensive therapy on the values of
heart rate (HR) and blood pressure (BP) before, during and after surgical
intervention, we examined a group of 95 patients at the Orthopedic and
Traumatology Clinic in Niš.
Patients with arterial
hypertension (n = 68) were divided in two groups, depending on antihypertensive
medicament therapy during hospitalization before the intervention. A group of 33
hypertensive patients was treated with beta blocker (BB group), while 35
patients were treated with angiotenzin converting enzyme inhibitor plus beta
blocker (ACEI+BB group). In all groups, both clinical examination and a standard
ECG were done. The values of HR and BP were measured on admission, before,
during and after the operation. Endotracheal general anesthesia was administered
in all subjects.
The values of systolic (SBP) and diastolic (DBP) blood
preassure as well as of HR on admission were signifficantly higher in both
groups of hypertensive patients than in controls. Antihypertensive therapy in BB
and ACEI+BB group brought about the reduction of HR and BP before the
intervention compared to the values on admission.
Before the intervention, there
were no significant differences in SBP and DBP beween BB and ACEI+BB group,
while HR was signifficantly lower in BB than in ACEI+BB group (p < 0,05).
During
the operation, the value of HR in BB group was signifficantly less than in
controls (p < 0,00001) and ACEI+BB group (p < 0,00001), while there were no
signifficant differences in BP between the three examinated groups during as
well as after the intervention. After the operation, the value of HR was
significantly less in BB group and ACEI+BB group compared to the controls (p <
0,0001 and p < 0,001).
Our results showed that the treatment with BB and the
combination of ACEI+BB group before the planned surgical intervention,
significantly reduced HR and BP in hypertensive patients and provided good
haemodynamic stability during and immediately after the operation. This confirms
the value of BB and ACEI in patients with verified long-lasting as well as newly
discovered hypertension, to whom the general anaesthesia will be administered.
Acta Medica Medianae 2005; 44(2): 11-16.
Key words: hypertensive patients, heart rate, blood pressure, beta
blockers, enzyme inhibitors