Today's strategies for treating postoperative hypertension. Immediate evaluation and targeted treatment are required.

Postoperative hypertension, though transient, requires immediate attention. Clinical variables include the patient's preoperative blood pressure, medications, and acute medical status; the surgical procedure performed; and the physiologic changes induced by surgery. Evaluate and treat any reversible causes of hypertension. Initiate drug therapy when organ failure or dysfunction is present or when the patient is at high risk for such complications. In choosing an agent, look for ease of administration, titratability of blood pressure response, rapid onset and cessation of action, and a low incidence of adverse effects. Options are nitrovasodilators, calcium channel blockers, ACE inhibitors, direct-acting vasodilators, adrenergic blockers, and neuromodulators (narcotics and anesthetics).