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Taking Lorsartan and Metoprolol, exhibits white coat syndrome, high BP. How to normal BP before operation?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 410 Questions
My Wife is on the following regimen for her BP.
One 100 mg Lorsartan Potassium tab @ 10 a.m.
One 50 mg Metoprolol SUCC ER @ 11 p.m.
At home this has been keeping her BP within an acceptable range.
The last two nights the readings were approximately 115/59...Heart Rate about 65.
However, she typically exibits White Coat Syndrome in a clinical setting.
On April 11th she had a pre-op screening and showed 220/97.
First they transferred her over to ER.
Then they said the surgery had to be postponed until her BP was under control.
What can be done before a pre-op exam to head-off the high readings. And, assuming we cross that
hurdle, what would need to be done on the day of the actual surgery?
We appreciate your kind consideration. XXXXXXX L. XXXXXXX
Posted Sun, 19 May 2013 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 10 hours later

Thanks for the query.

Blood pressure looks quite normal to me except the pre-operative elevation. This can be mitigated by giving adequate tranquilizers and anxiolytics such as alprazolam.

It doesn't generally recur on operation table with adequate pre-medications; but even it occurs can be taken care by some injections such esmolol.

One more additional thing that can be done is to switch over to long acting BP medicines. Discuss with her cardiologist.

Let me know if you need clarifications.

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Follow-up: Taking Lorsartan and Metoprolol, exhibits white coat syndrome, high BP. How to normal BP before operation? 39 hours later
Dear Sir:

What would be an example of what you refer to as a "long acting BP medicine"?

Thank you
Answered by Dr. Prabhakar C Koregol 36 hours later
Telmisartan, Amlodepine Long acting /sustained release metoprolol. There are many more in fact.
Above answer was peer-reviewed by
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