The importance of beta blockers and angiotenzin converting enzyme inhibitors for preoperative treatment in hypertensive patients

In order to evaluate the effects of antihypertensive therapy on the values of heart rate (HR) and blood pressure (BP) before, during and after surgical intervention, we examined a group of 95 patients at the Orthopedic and Traumatology Clinic in Nis. Patients with arterial hypertension (n = 68) were divided in two groups, depending on antihypertensive medicament therapy during hospitalization before the intervention. A group of 33 hypertensive patients was treated with beta blocker (BB group), while 35 patients were treated with angiotenzin converting enzyme inhibitor plus beta blocker (ACEI+BB group). In all groups, both clinical examination and a standard ECG were done. The values of HR and BP were measured on admission, before, during and after the operation. Endotracheal general anesthesia was administered in all subjects. The values of systolic (SBP) and diastolic (DBP) blood pressure as well as of HR on admission were significantly higher in both groups of hypertensive patients than in controls. Antihypertensive therapy in BB and ACEI+BB group brought about the reduction of HR and BP before the intervention compared to the values on admission. Before the intervention, there were no significant differences in SBP and DBP between BB and ACEI+BB group, while HR was significantly lower in BB than in ACEI+BB group (p < 0,05). During the operation, the value of HR in BB group was significantly less than in controls (p < 0,00001) and ACEI+BB group (p < 0,00001), while there were no significant differences in BP between the three examined groups during as well as after the intervention. After the operation, the value of HR was significantly less in BB group and ACEI+BB group compared to the controls (p < 0,0001 and p < 0,001). Our results showed that the treatment with BB and the combination of ACEI+BB group before the planned surgical intervention, significantly reduced HR and BP in hypertensive patients and provided good haemodynamic stability during and immediately after the operation. This confirms the value of BB and ACEI in patients with verified long-lasting as well as newly discovered hypertension, to whom the general anesthesia will be administered.