Introduction to arterial hypertension and anaesthesia: a look beyond the numbers

Arterial hypertension represents the most frequent cardiovascular abnormality encountered by an anaesthetist during the peri-operative period. The diagnosis of arterial hypertension prompts anaesthetists to make far-reaching clinical decisions regarding the pre-operative evaluations of the possible risks for their patients during anaesthesia and surgery, cancellation of surgery in patients with poorly controlled hypertension, adjustment of anti-hypertensive drug therapy, optimal anaesthetic management and safe use of intravenous agents for blood pressure control, to name only a few. Over the past few years, the understanding of the pathophysiology of hypertension has increased considerably, and many new anti-hypertensive drugs have been introduced that may produce significant interactions with anaesthesia. This introductory chapter shows how the new knowledge that is presented in this book may be used for all of the clinical decisions mentioned above, and it attempts to convince the readers that arterial hypertension means much more than just the ‘number of millimetres of mercury’.