High blood pressure (hypertension) is often called the “silent killer” because it is incredibly common yet frequently ignored by patients until it leads to a crisis. However, when you are scheduled for a procedure, your blood pressure moves to the center stage of your medical care. Surgery combined with uncontrolled BP creates a set of risks that can complicate even the most routine operations. Taking the time to stabilize your levels beforehand is not just a suggestion; it is a critical safety requirement for a successful outcome.
How High BP Affects Surgery
When you are on the operating table, your body is in a state of physiological stress. If your blood pressure is already high, this stress can push your cardiovascular system to its limits.
- Anesthesia Response: General and spinal anesthesia can cause sudden fluctuations in blood pressure. If your baseline is uncontrolled, these swings can become unpredictable, putting unnecessary strain on your heart and brain during the procedure.
- Bleeding Risk: High pressure in the arteries makes it more difficult for blood to clot effectively at the surgical site. This increases the risk of excessive bleeding both during the operation and in the immediate hours following it.
- Recovery Issues: Hypertension slows down the healing process. It can lead to poor wound healing and increases the likelihood of post-operative complications such as stroke or heart strain during the delicate recovery phase.
Surgeries Where BP Control Is Critical
While BP management is important for all medical interventions, it is absolutely vital for surgeries that involve significant fluid shifts or delicate tissue.
- Abdominal Surgeries: Procedures involving the organs in the abdomen require stable blood flow to ensure the internal tissues heal without leaking or infection.
- Colorectal Surgeries: These procedures often involve older demographics where hypertension is prevalent, making pre-operative stability a top priority.
- Orthopedic Surgeries: Major bone surgeries, such as hip or knee replacements, involve significant physiological stress and blood loss, requiring a robust and
stable heart.
Key Diagnostic Checks and What They Reveal
To get a 360-degree view of your heart’s health, a specialist may advise:
Blood Pressure Stability: Chronic high BP can lead to thick heart walls (hypertrophy). Knowing your baseline helps the anesthesiologist keep your BP within a “safe zone” throughout the operation.
ECG (Electrocardiogram): This is the baseline test. It records the electrical activity of your heart to detect arrhythmias (irregular heartbeats) or signs of a previous, silent heart attack that you might not even have felt.
Echocardiogram (Echo): This is an ultrasound of the heart. It allows the doctor to see the heart’s valves in motion and measure the “ejection fraction”—essentially a score of how well your heart pumps blood out to the rest of your body.
The Colorectal Surgery Context
In procedures such as piles surgery, especially in patients with long-standing high blood pressure, pre-surgical cardiac evaluation plays a crucial role. Because these treatments are often elective, there is a perfect opportunity to optimize the patient’s health before the first incision is made.
Surgeons like Dr. Atul Patil, Colorectal and Piles Specialist in Rahatani, routinely ensure such patients receive appropriate cardiac clearance before treatment. By coordinating with a cardiologist, the surgical team can manage medications—such as blood pressure pills and blood thinners—to ensure the safest possible environment for the patient. This collaborative approach ensures that the focus remains on permanent relief from piles without compromising the patient’s cardiovascular safety.
The Importance of Cardiac Clearance
For patients over the age of 40 or those with long-standing hypertension, a pre-surgical cardiac evaluation is essential to identify “target organ damage”—damage already done to the heart, brain, or kidneys.
For procedures like piles or colorectal surgeries, especially in patients with high blood pressure, diabetes, or previous heart issues, a pre-surgical cardiac evaluation helps minimize surgical risk. In Pune, specialists such as Dr. Atul Patil, Colorectal and Piles Specialist in Rahatani, work closely with cardiologists to ensure patients receive appropriate cardiac clearance before treatment.
| Blood Pressure Category | Measurements (mmHg) | Surgical Action |
| Optimal for Surgery | < 130/80 | Proceed as planned. |
| Stage 1 or 2 Hypertension | < 180/110 | Generally safe to proceed with monitoring. |
| Severe Hypertension | > 180/110 | Postpone elective surgery for better control. |
Visit Us: Dr. Praveen Pawal Cardiac Centre, Baner, Pune.
Click here to book a pre-surgical cardiac evaluation
