November 16, 2017 – Surgery, Blood Pressure and Age

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Anchor lead: How aggressively should blood pressure be lowered during an operation in an older person? Elizabeth Tracey reports

A person’s blood pressure before surgery should be a consideration in how low to go during surgery, a recent study asserts, finding that the likelihood of delirium may be increased the more aggressively blood pressure is lowered in an older person. Kevin Gerold, an anesthesiologist at Johns Hopkins, comments.

Gerold: A healthy 80 year old is not the same as a healthy forty year old. Our ability to compensate around stressful events like surgery can be impaired. Our ability to maintain a normal perfusion state in response to a changing blood pressure may diminish. The exact numbers become difficult to predict but I think it’s safe to say that as we age we are probably less able to tolerate significant drops in our blood pressure without some change in cognitive function, at least temporarily.  :30

Gerold says families and loved ones can certainly include questions about blood pressure in their preoperative consult. At Johns Hopkins, I’m Elizabeth Tracey.