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The long term end-organ effects add to patient morbidity and mortality.

Ensuring cardiovascular stability and pre-optimization of BP allows safe manipulation of physiology and pharmacology during anaesthesia.

Definition Acute severe elevations in BP have several terms.

Accurate adjustment of treatment and monitoring of patient’s response to therapy are essential to safe and effective management of perioperative hypertension.Signs and symptoms of hypertensive crisisinclude severe chest pain, severe headache accompanied by confusion and blurred vision, nausea and vomiting, severe anxiety, shortness of breath, seizures and unresponsiveness.Pathogenesis Humoral vasoconstrictors released in the hypertensive crises episodes result in a sudden increase in systemic vascular resistance.Endothelial injury accompanies severe elevations of BP resulting in fibrinoid necrosis of the arterioles with the deposition of platelets and fibrin, and a breakdown of the normal autoregulatory function.The resulting ischemia speeds the further release of vasoactive substances completing a vicious cycle.

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