Hypertension Following Coronary Artery Bypass Surgery Role of Preoperative Propranolol Therapy

Paul K. Whelton, John T. Flaherty, Niall P. Macallister, Levi Watkins, Alan Potter, Dolores Johnson, R. Patterson Russell, W. Gordon Walker

Research output: Contribution to journalArticlepeer-review

Abstract

Over a 9-month period, the incidence and characteristics of hypertension followtng coronary artery bypass surgery were studied in a group of 52 patients. Hypertension occurred in 61% of the patients and was characterized by an increase in arterial blood pressure of 35 ± 2 mm Hg mean ± SEM during the early postoperative period. Preoperative blood pressures and hemodynamk variables were similar in those who developed hypertension and those who remained normotenshe. Ninety-four percent of those who developed hypertension as compared to only 40% of those who remained normotensive received propranolol during the 24 hours preceding surgery (x2= 15.4; p < 0.001). Maximal blood pressures during the first 5 hours following the termination of cardiopulmonary bypass were significantly positively correlated with preoperative propranolol dosage (p < 0.01). Hypertension was not associated with significant changes in plasma renin activity or angiotensin II levels, but concomitant plasma catecholamine concentrations were elevated significantly (p < 0.005). However, a similar rise in plasma catecholamine concentrations was found in those who remained normotensive. Hypertension was associated with an increase in systemic vascular resistance (p < 0.001) and left ventricular stroke work index (p < 0.05), and a fall in stroke volume (p < 0.005) and cardiac index (p < 0.001). These studies suggest that hypertension following coronary artery bypass surgery is common, results from an increase in systemic vascular resistance, is not renin-angiotensin mediated, and may, in part, be related to preoperative propranolol administration.

Original languageEnglish (US)
Pages (from-to)291-298
Number of pages8
JournalHypertension
Volume2
Issue number3
DOIs
StatePublished - Jan 1 1980

Keywords

  • Coronary artery bypass surgery
  • Hemodynamics
  • Hypertension
  • Renin activity catecholamine

ASJC Scopus subject areas

  • Internal Medicine

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