title: Management of acute postoperative hypertension for reducing cardiovascular complications in cancer patients: when and how aggressively?
abstract: OBJECTIVE
  We sought to determine what factors cardiovascular complications (CVCs) correlate with in cancer patients with acute postoperative hypertension (APH) and to define when and how aggressively to treat this disorder in the present study.
  
  
  METHODS
  A retrospective observational study of cancer patients with postoperative hypertension at a single intensive care unit between July 2007 and June 2013 was conducted. The outcome of interest was the incidence of a CVC.
  
  
  RESULTS
  There were 1162 patients enrolled, of which 92 (7.9%) experienced one or more CVCs. Preexisting hypertension (OR 38.3, 95% CI 3.2-457.4, P = 0.004) and choice of vasodilator (OR 6.5, 95% CI 2.3-18.6, P = 0.000) were predictors of a CVC. Cardiovascular complications were less likely to occur if pain was relieved efficiently during the postoperative period (OR 15.9, 95% CI 1.9-130.1, P = 0.01). Furthermore, there were increased CVCs among patients with postoperative hypertensive crises compared to those with stage 1 or stage 2 hypertension with the treatment threshold for systolic blood pressure (OR 5.7, 95% CI 2.0-16.5, P = 0.001) or diastolic blood pressure (OR 6.0, 95% CI 1.8-20.3, P = 0.004).
  
  
  CONCLUSIONS
  To reduce CVCs, APH may be defined and managed as a hypertensive crisis in cancer patients.
authors.affiliation: Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P.R. China.
authors.forename: Ning
authors.initials: N
authors.lastname: Lou
authors.affiliation: Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P.R. China.
authors.forename: Daofeng
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P.R. China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Clinical Nutrition, Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Ye
authors.affiliation: Department of Critical Care Medicine, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, P.R. China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
mesh_terms: D001794:Blood Pressure; D006801:Humans; D006973:Hypertension; D009369:Neoplasms; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Acute postoperative hypertension; cancer; cardiovascular complication; surgery