SYSTEMIC HYPERTENSION ASSOCIATED WITH CORONARY-ARTERY BYPASS SURGERY - PREDISPOSING FACTORS, HEMODYNAMIC CHARACTERISTICS, HUMORAL PROFILE, AND TREATMENT

Abstract

Systemic hypertension occurs in more than 1/3 of patients having coronary artery bypass graft (CABG) operations. Patients (100) undergoing CABG were described. Certain preoperative clinical, angiographic and biochemical factors predispose to the development of perioperative hypertension. These included a well-documented history of hypertension, an elevated blood pressure and day prior to operation, greater than 50% obstruction of the left main coronary artery and increased levels of dopamine .beta.-hydroxylase (DBH). The hemodynamic pattern of perioperative hypertension was that of an increased systemic vascular resistance which was associated with increased levels of plasma catecholamines and plasma renin activity (PRA). Nitroprusside was effective in managing CABG hypertension, although other, more specific therapy may be preferable.