Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

Guideline of the month - measuring hypertension before surgery

February’s guideline of the month

blood pressure check3x2 - SUO

 

The guideline

A document produced jointly by the Association of Anaesthetists of Great Britain and Ireland and the British Hypertension Society, which aims to prevent a diagnosis of hypertension being the reason for the delay or cancellation of planned surgery.

Key points for GPs

• GPs should only refer patients for elective surgery with mean blood pressures in primary care in the past 12 months of less than 160mmHg systolic and 100mmHg diastolic.

• Patients who remain hypertensive despite optimal treatment, or who refuse treatment, may still be referred.

• GPs should document blood pressure readings in the referral letter. Surgeons are asked to request blood pressure readings from GPs for the past 12 months if they are not documented.

• Patients who present to pre-operative assessment clinics without documented readings should proceed to elective surgery if clinic blood pressures are below 180mmHg systolic and 110mmHg diastolic.

Practical issues

Persuading hospitals they do not need to take a pre-operative reading, as there have been reports of patients being rejected on the basis of a single reading exceeding 160/100mmHg.

Expert comment

Co-chair of the guidelines working party, and Whitby GP Dr Terry McCormack said: ‘We wanted to create a commonsense document that everybody can use as a benchmark. Blood pressure readings need to come from primary care, since there is already recognition that this is the best place to have them done.

‘It shouldn’t be too big an ask for GPs to include blood pressure in a referral document – the guidelines are intended to make both GPs’ and patients’ lives easier.’

The guideline

Hartle A, McCormack T, Carlisle J et al. The measurement of adult blood pressure and management of hypertension before elective surgery. Anaesthesia 2016, online 17 Jan

Rate this article  (4.67 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (1)

  • Blimey. An outbreak of common sense. Whatever next?

    I have printed out multiple copies of the source article as I will inevitably need them to staple to my exasperated re-referral letters in the weeks to come. Oh, for some real pathology to break up the iatrogenic admin nonsense from my local DGH.

    Unsuitable or offensive? Report this comment

Have your say