Measurement and management of adult blood pressure in the peri-operative period: updated guidelines from the Association of Anaesthetists and the British and Irish Hypertension Society

Plain Language Summary Keeping a patient's blood pressure steady during surgery is a very important job for anaesthetists. Some things, like stopping or starting blood pressure medicine, and the types of anaesthetic used, can make blood pressure go up or down a lot – especially in people who already have high blood pressure. This update is based on earlier advice from 2016 made by two groups: the Association of Anaesthetists and the British and Irish Hypertension Society. A team of experts read the newest research and worked together to make clear, updated rules. The new advice explains how to look after adults having planned (non-emergency) surgery; it doesn't cover heart, pregnancy or hormone-related operations. The guidelines explain: when and how to measure blood pressure; what blood pressure numbers mean surgery might need to be delayed; and how to manage blood pressure before, during, and after surgery. Some main points include the following: Hospitals can accept patients for surgery if their blood pressure is below 160/100 when checked at a clinic, or below 155/95 when checked at home in the past year. If someone's blood pressure has not been recently checked by their doctor, they can still go ahead with surgery if their clinic reading is below 180/120, or their home reading is below 175/115. Looking after blood pressure around the time of surgery needs careful balance – doctors must keep patients safe during the operation while also thinking about their long-term heart health. Good communication between GPs, hospital staff and patients is very important to keep everyone informed.