Optimal Blood Pressure Before Carotid Surgery

At what level should a patient's blood pressure be before he or she has carotid surgery?

---- MD

Before carotid endarterectomy, an ideal blood pressure is less than 130 mm Hg systolic and less than 80 mm Hg diastolic. Even more important is control of the patient's heart rate, which should be lowered to between 60 and 70 beats per minute-by means of β-blocker therapy if necessary. Both maneuvers reduce the risk of complications of carotid endarterectomy.

---- Mahmoud B. Malas, MD
Chief of Endovascular Surgery
Johns Hopkins Bayview Medical Center
Baltimore