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December 22, 1975

Antihypertensive Medication And Surgery-Reply

Author Affiliations

Stanford University School of Medicine Stanford, Calif

JAMA. 1975;234(12):1222. doi:10.1001/jama.1975.03260250013009

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In Reply.—  The main point made by Drs Geer and Greenhow is that, in contrast to our suggestion that medication be discontinued for some hypertensive patients, antihypertensive medication is safely maintained during anesthesia and surgery. In view of the increased use of continuous monitoring devices in operating rooms and the increased familiarity with cardiovascular pharmacology by anesthesiologists, such procedure is probably safer than we implied.All references the authors supply allude to the controversy that still exists in the medical literature regarding the hazards of continuing hypotensive therapy at a time when hypotension is induced by anesthetic agents also. Only one article cited (Prys-Roberts et al1) by Drs Geer and Greenhow contained data regarding the cardiovascular effects of anesthesia on hypertensive patients. In this study, three of 15 patients receiving antihypertensive drugs "... developed marked hypotension following induction of anesthesia," and the events recorded in one of these patients provide