What is the best course of action for an elderly female patient with uncontrolled Hypertension (HTN) and Diabetes Mellitus (DM), presenting with elevated blood pressure and hyperglycemia, who is scheduled for elective surgery?

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Proceed with Surgery and Optimize Blood Pressure Perioperatively

This patient's blood pressure of 160/95 mmHg is below the critical threshold of 180/110 mmHg, so elective surgery should proceed without postponement, but the GP should be informed to optimize her antihypertensive regimen. 1

Blood Pressure Assessment Algorithm

The most recent 2024 AHA/ACC guidelines and the 2016 British/Irish joint guidelines provide clear thresholds for surgical decision-making:

  • BP <160/100 mmHg: Proceed with surgery 1
  • BP 160-179/100-109 mmHg: Proceed with surgery but inform GP for optimization 1
  • BP ≥180/110 mmHg: Defer surgery and refer back to primary care for blood pressure control 1, 2

This patient's BP of 160/95 mmHg falls into the middle category—proceed with surgery while initiating medication optimization. 1

Rationale for Proceeding

The evidence does not support routine postponement for stage 1-2 hypertension without target organ damage. 1 Multiple studies have failed to demonstrate that delaying surgery to optimize blood pressure in this range reduces perioperative cardiovascular events. 1 The 2024 AHA/ACC guidelines only recommend considering deferral (Class 2b recommendation) for patients with BP ≥180/110 mmHg who have additional cardiovascular risk factors and are undergoing elevated-risk surgery. 1

Diabetes Management Considerations

Her glucose of 9.1 mmol/L (164 mg/dL) is acceptable for proceeding with surgery:

  • Target postoperative glucose <180 mg/dL (10 mmol/L) to reduce infection risk 2
  • Continue basal insulin at reduced dose perioperatively 2
  • Hold SGLT-2 inhibitors the day before and day of surgery due to euglycemic ketoacidosis risk 2
  • Continue GLP-1 receptor agonists if applicable, with aspiration risk mitigation 2

Perioperative Medication Management

Continue most antihypertensive medications throughout the perioperative period (Class 2a recommendation): 1, 2

  • Beta-blockers: Must continue to avoid rebound hypertension, MI, and arrhythmias 2
  • Calcium channel blockers: Continue throughout perioperative period 3
  • Clonidine: Continue to avoid harmful rebound hypertension 2
  • ACE inhibitors/ARBs: Consider holding on day of surgery due to intraoperative hypotension risk, but restart as soon as clinically feasible postoperatively 1, 2

Intraoperative Blood Pressure Targets

Maintain MAP ≥60-65 mmHg or SBP ≥90 mmHg to reduce myocardial injury risk (Class I recommendation). 1 In this elderly patient with chronic hypertension, consider higher targets to maintain adequate organ perfusion. 1

Postoperative Management

Restart antihypertensive medications as soon as clinically reasonable (Class I recommendation) to avoid complications from postoperative hypertension. 1, 4 Delaying resumption has been associated with increased 30-day mortality. 4

If unable to take oral medications, use IV agents as bridge therapy:

  • Nicardipine: First-line for postoperative hypertension 4, 3
  • Labetalol: Alternative first-line option 4

Critical Pitfalls to Avoid

  • Do not postpone surgery for one month—this is unnecessary and unsupported by evidence for BP <180/110 mmHg 1
  • Avoid abrupt discontinuation of beta-blockers or clonidine—this can cause life-threatening rebound hypertension 2
  • Do not over-aggressively lower BP postoperatively—target approximately 10% above baseline to avoid hypotension-related complications 4
  • In elderly patients (≥65 years), exercise caution with antihypertensive intensification—overly aggressive treatment increases risk of hypotension and associated morbidity 1, 4

Optimal Answer: B - Adjust Medications

The correct answer is B: Adjust her HTN and DM medications. However, this should occur concurrently with proceeding to surgery, not as a reason for postponement. Inform her primary care physician to optimize her antihypertensive regimen for long-term control, ensure her diabetes medications are appropriately managed perioperatively, and proceed with the planned elective surgery. 1, 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Perioperative Medication Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Perioperative Management of Patients on Nicardipine

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Immediate Postoperative Hypertension

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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