Author(s): Syed Saud Ahmed, Ahmed Mustafa Shariff, Janet Jacob, Shweta Srivatsa

Email(s): janetjacob1992@gmail.com

DOI: 10.5958/0974-360X.2020.00669.1   

Address: Syed Saud Ahmed1, Ahmed Mustafa Shariff1, Dr. Janet Jacob2*, Dr. Shweta Srivatsa3
1Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bangalore-560035, Karnataka, India.
2Department of Pharmacy Practice, Faculty of Pharmacy, Krupanidhi College of Pharmacy, Bangalore-560035, Karnataka, India.
3Consultant Clinical Pharmacologist, Sri Shankara Cancer Hospital and Research Centre, Basavanagudi, Bengaluru-560004, Karnataka, India.
*Corresponding Author

Published In:   Volume - 13,      Issue - 8,     Year - 2020


ABSTRACT:
Objectives: The aim of this study was to determine the prescribing pattern of antihypertensive medication in cancer patients undergoing surgery, to assess the control of hypertension postoperatively and to assess the cardiovascular complications post operatively if any in patients who had been admitted in a tertiary care hospital, South Bangalore, India. Subject and methods: A prospective observational study was carried out for 6 months in 152 patients of above 40yrs of age who were on antihypertensive medication and undergoing cancer surgery. Patients pre and post-operative blood pressure readings were recorded (3 readings at 6hr time interval) and patients pre and post-operative antihypertensive medication were recorded. The data was analyzed. Results: Calcium channel blockers (31.74%) and angiotensin receptor blockers (49.20%) were mostly prescribed monotherapy agents. ARB + diuretics (42.16%) were mostly prescribed combination therapy agents followed by ARB+CCB (18.07%), CCB + beta blocker (14.45%), CCB + alpha blocker (10.84%), ARB + beta blocker (9.63%). Amlodipine + atenolol was found to be significant in controlling of B. P in hypertensive cancer patients with Prob >F= 0.013, and other drugs were found to be not significant. Conclusion: Management of hypertension preoperatively is important to prevent peri and postoperative cardiovascular complications. It was found that patient taking combination antihypertensive agents like calcium channel blocker and alpha blocker or angiotensin receptor blocker and diuretics were more effective in controlling their hypertension. Calcium channel blockers and angiotensin receptor blockers were commonly prescribed monotherapy agents. Amlodipine + atenolol was found to be most prescribed agent and effective in blood pressure control in hypertensive cancer patients.


Cite this article:
Syed Saud Ahmed, Ahmed Mustafa Shariff, Janet Jacob, Shweta Srivatsa. A Study to assess the management of hypertension for pre and post-operative care hypertensive cancer patients. Research J. Pharm. and Tech. 2020; 13(8):3781-3786. doi: 10.5958/0974-360X.2020.00669.1

Cite(Electronic):
Syed Saud Ahmed, Ahmed Mustafa Shariff, Janet Jacob, Shweta Srivatsa. A Study to assess the management of hypertension for pre and post-operative care hypertensive cancer patients. Research J. Pharm. and Tech. 2020; 13(8):3781-3786. doi: 10.5958/0974-360X.2020.00669.1   Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2020-13-8-42


REFERENCES:
1    Hernandez-Vila E. A review of the JNC 8 blood pressure guideline. Texas Heart Institute Journal. 2015 Jun;42(3):226-8.
2    Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Journal of the American College of Cardiology. 2014 Dec 9;64(22):e77-137.
3    Foex P, Sear JW. The surgical hypertensive patient. Continuing Education in Anaesthesia, Critical Care and Pain. 2004 Oct 1;4(5):139-43.
4    Weksler N, Klein M, Szendro G, Rozentsveig V, Schily M, Brill S, Tarnopolski A, Ovadia L, Gurman GM. The dilemma of immediate preoperative hypertension: to treat and operate, or to postpone surgery?. Journal of clinical anesthesia. 2003 May 1;15(3):179-83.
5    Gómez-Henao PA, Carreño-Dueñas JA. Cardiovascular pre-anesthesia evaluation in oncological surgery. Colombian Journal of Anesthesiology. 2016 Jan 1;44(1):17-22.
6    Hogenson KD. Acute postoperative hypertension in the hypertensive patient. Journal of post anesthesia nursing. 1992 Feb;7(1):38-44.
7    Fleisher LA. Preoperative evaluation of the patient with hypertension. Jama. 2002 Apr 24;287(16):2043-6.
8    Soto-Ruiz KM, Peacock WF, Varon J. Perioperative hypertension: diagnosis and treatment. Neth J Crit Care. 2011 Jun 1;15(3):143-8.
9    Lou N, Wang D, Wang Z, Ye W, Liu X. Management of acute postoperative hypertension for reducing cardiovascular complications in cancer patients: when and how aggressively? Turkish Journal of Medical Sciences. 2016 Dec 20;46(6):1634-40.
10    Himmelmann A, Kjeldsen S, Hedner T. Recent hypertension guidelines: JNC-7 and 2003 ESH/ESC. Blood pressure. 2003 Jan 1;12(4):196-7.
11    Varon J, Marik PE. Perioperative hypertension management. Vascular Health and Risk Management. 2008 Jun;4(3):615.
12    Tripathi KD. Essentials of Medical Pharmacology. JP Medical Ltd; 2013 Sep 30.
13    Mouhayar E, Salahudeen A. Hypertension in cancer patients. Texas Heart Institute Journal. 2011;38(3):263.
14    Jeschke E, Ostermann T, Vollmar HC, Kroz M, Bockelbrink A, Witt CM et.al. BMC FamPract. 2009;10: 178
15    Alam MN, Hoda MQ. Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients in Tertiary Care Hospital. International Journal of Medi Pharm Research. 2017; 3:259-63.
16    Kale A, Maniyar YA, Kale A. Prescribing patterns of antihypertensive drugs in a tertiary care hospital. Sch Acad J Pharm. 2013; 2(5): 416-8.
17    Laslett L. Hypertension. Preoperative assessment and perioperative management. Western journal of medicine. 1995 Mar;162(3):215.
18    Bertrand M, Godet G, Meersschaert K, Brun L, Salcedo E, Coriat P. Should the angiotensin II antagonists be discontinued before surgery? Anesthesia and Analgesia. 2001 Jan 1;92(1):26-30.
19    Rosenman DJ, McDonald FS, Ebbert JO, Erwin PJ, LaBella M, Montori VM. Clinical consequences of withholding versus administering renin‐angiotensin‐aldosterone system antagonists in the preoperative period. Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine. 2008 Jul;3(4):319-25.
20    Howell SJ, Sear JW, Foex P. Hypertension, hypertensive heart disease and perioperative cardiac risk. British journal of anaesthesia. 2004 Apr 1;92(4):570-83.
21    Burns J, Persaud-Sharma D, Green D. Beyond JNC 8: implications for evaluation and management of hypertension in underserved populations. Actacardiologica. 2019 Jan 2;74(1):1-8
22    Singla N, Warltier DC, Gandhi SD, Lumb PD, Sladen RN, Aronson S, Newman MF, Corwin HL. Treatment of acute postoperative hypertension in cardiac surgery patients: an efficacy study of clevidipine assessing its postoperative antihypertensive effect in cardiac surgery-2 (ESCAPE-2), a randomized, double-blind, placebo-controlled trial. Anesthesia and Analgesia. 2008 Jul 1;107(1):59-67.
23    McGuirt WF, May JS. Postoperative hypertension associated with radical neck dissection. Archives of Otolaryngology–Head and Neck Surgery. 1987 Oct 1;113(10):1098-100.
24    Cheung AT. Exploring an optimum intra/postoperative management strategy for acute hypertension in the cardiac surgery patient. Journal of cardiac surgery. 2006 Mar; 21: S8-14.
25    Abdelwahab W, Frishman W, Landau A. Management of hypertensive urgencies and emergencies. The Journal of Clinical Pharmacology. 1995 Aug;35(8):747-62.
26    Prys-Roberts C, Foex P, Biro GP, Roberts JG. Studies of anaesthesia in relation to hypertension V: adrenergic beta-receptor blockade. British Journal of Anaesthesia. 1973 Jul 1;45(7):671-81.
27    Haas CE, LeBlanc JM. Acute postoperative hypertension: a review of therapeutic options. American Journal of Health-System Pharmacy. 2004 Aug 15;61(16):1661-73.
28    Twersky RS, Goel V, Narayan P, Weedon J. The risk of hypertension after preoperative discontinuation of angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists in ambulatory and same-day admission patients. Anesthesia and Analgesia. 2014 May 1;118(5):938-44.
29    Gal TJ, Cooperman LH. Hypertension in the immediate postoperative period. British Journal of Anaesthesia. 1975 Jan 1;47(1):70-4.
30    Adejumo O, Okaka E, Iyawe I. Prescription pattern of antihypertensive medications and blood pressure control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria. Malawi Medical Journal. 2017;29(2):113-7.
31    Smith I, Jackson I. Beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers: should they be stopped or not before ambulatory anaesthesia?. Current Opinion in Anesthesiology. 2010 Dec 1;23(6):687-90.
32    Jarari N, Rao N, Peela JR, Ellafi KA, Shakila S, Said AR, Nelapalli NK, Min Y, Tun KD, Jamallulail SI, Rawal AK. A review on prescribing patterns of antihypertensive drugs. Clinical Hypertension. 2015 Dec;22(1):7.
33    James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama. 2014 Feb 5; 311(5):507-20.
34    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, IzzoJr JL, Jones DW, Materson BJ, Oparil S, Wright Jr JT, Roccella EJ. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-71.
35    Sansone P, Pace MC, Passavanti MB, Pota V, Tavano A, Aurilio C. Journal of Hypertension: Open Access. analgesia (if administered parenterally, epidural or intrathecal). 2015;5:11.

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