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Severe hypertension at preassessment — FRCA Final MCQ

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ModeratePerioperative MedicineSevere hypertension at preassessmentFRCA Final

A 45-year-old woman is found to have blood pressure 192/116 mmHg at preassessment before elective varicose vein surgery. She has headache but no chest pain or neurological deficit. The GP record shows repeated readings around 150/92 mmHg. What is the most appropriate management?

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Correct answer: D — Postpone elective surgery and arrange same-day assessment for severe hypertension symptoms

A markedly elevated preoperative blood pressure with headache requires assessment for hypertensive urgency or emergency before elective low-risk surgery. Proceeding is inappropriate without confirming risk and treating symptoms. Acute IV antihypertensive treatment solely to get an elective case done is poor practice. Contemporary guidance emphasises validated measurement, end-organ symptoms and communication with primary care.

Reference: Association of Anaesthetists peri-operative blood pressure guideline 2026