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Postoperative Hypertension: When Blood Pressure Cuff and Arterial Line Disagree

Hypertension is a commonly encountered condition by anesthesiologists yet there is no clearly defined approach to monitoring and managing blood pressure in the perioperative period. In this review, we focus on common dilemmas in perioperative management of hypertensive patients including preoperative evaluation and indications for postponement of elective procedures; appraise the commonly used modes of perioperative blood pressure monitoring; discuss acute hypertension in the postoperative period and the role of blood pressure in discharge criteria for patients in the post-anesthesia care unit; and we review the relevant pathophysiology of organ perfusion in chronic hypertension and the implication for postoperative blood pressure management in hypertensive patients.