View clinical trials related to Perioperative Hypertension.
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Elevated blood pressure is the largest contributing risk factor to all-cause and cardiovascular mortality. According to the U.S. Preventive Services Task Force, hypertension affects nearly 30% of the adult population. Many patients remain undiagnosed, despite the consensus that screening and timely diagnosis is paramount. In this study, 108 ambulatory surgery patients with elevated blood pressure (160/90) that are not yet formally diagnosed with hypertension will be enrolled and alerted of their high blood pressure by a co-investigator MD. They will request permission to follow-up with the patient and the patient's primary care provider 6 months after the initial phone call to check in on the status of their diagnosis and any action taken (lifestyle changes, medication) to alleviate their high blood pressure. Patients will receive a follow-up letter/email at 6 and 3 months to remind them of their potential diagnosis.
This is a single centre, prospective, non-randomised clinical investigation to be undertaken at the Queen Elizabeth Hospital, Edgbaston, Birmingham. The clinical investigation will collect fully anonymised perioperative blood pressure data from patients undergoing elective high risk surgery. The Sponsor of this clinical investigation, Directed Systems Limited, is developing a new medical device, BP Assist, which provides guidance to anaesthetists in relation to the real-time management of patient cardiovascular physiology.
The incidence of conditions requiring surgical intervention increases with age, however there is a reported decline in the rates of elective surgical procedures in those over 65. This is associated with older patients being described as "less fit" and more at risk of postoperative complications, leading to decreased provision of surgical care to those at need. Exercise interventions have the potential to reverse some of the decline in cardiovascular fitness associated with aging and improve the elderly's' "fitness for surgery" and potentially allow increased access to surgical care for those most in need of it.
Perioperative hypertension is commonly associated with surgical craniotomy. As the sympathetic nervous system and the renin-angiotensin-aldosterone system play a key role in the development of this hypertension, preoperative single dose therapy with a -adrenergic receptor blocker or an angiotensin converting enzyme (ACE) inhibitor may be useful in preventing this. To assess this as well as to study potential markers of these two systems, the investigators will perform a randomized, double blind, placebo controlled study to compare the single dose effect of preoperative administration of a -receptor blocking drug (atenolol) and an ACE inhibitor (lisinopril) with a control group receiving a placebo tablet (glucose) on perioperative hypertension in craniotomy patients.