Ask Dr. Pane! I don’t have high blood pressure, but will it get canceled if it’s high because of nervousness?

At Atlantic Coast Aesthetics, we understand the period right before a procedure can be very stressful for patients. They have families, jobs, lives and things to do, and they’re understandably concerned about how their procedures and the postoperative restrictions on their lives will impact them. This is perfectly normal and most patients find their postop lives are not that different, or even better, than their preoperative lives. One effect of this stress is a spike in blood pressure, which leads to a common question that a patient asked our founder and Chief Medical Officer, Dr. Thomas A. Pane, during a recent Instagram Live segment. The patient asks, “I don’t have high blood pressure, but will it get canceled if it’s high because of nervousness?”

This is a great question, and one Dr. Pane was happy to answer because temporary high blood pressure due to typical preoperative stressors and “white coat syndrome” is a very different phenomenon than high blood pressure that causes alarm in a surgical team. Let’s see what Dr. Pane had to say, but first, let’s take a closer look at how blood pressure works.

When your heart pumps blood through your body, it does so by contracting and expanding. Most healthy people have a baseline blood pressure of around 110 over 70. This means when the heart expands, pushing blood through the body, it does so at a pressure of about 110 mm of mercury, the same unit of measure used to calculate barometric pressure for weather readings. When the heart is resting between contractions, the blood pressure is about 70 mm of mercury. The first number, or the top number, is called the “systolic” blood pressure, while the second or bottom number is your “diastolic” blood pressure. A number of factors can impact your blood pressure readings, such as overall health, stress, diet and exercise.

As Dr. Pane explains, “If your blood pressure is high due to nervousness, usually the top number (systolic) will be a little higher than usual and the other number (diastolic) will be okay. So we look at you and get a sense of [where your normal blood pressure is]. If someone has a history of high blood pressure and stopped their medication a couple of days before [on the surgeon’s orders for preop preparation], but they have a known history of high blood pressure and it’s well-controlled, anesthesia usually isn’t too worried about that. They may give you a little extra something.

“Where you end up getting canceled is when you have no history of high blood pressure and you come in and both numbers are high. In that case, that’s not nervousness. That’s more significant. For elective procedures we simply can’t take someone in that situation into the OR. It’s not safe. The fact that probably nothing would happen doesn’t matter, because if something does happen it won’t be good. If you have a complication in there, there’s just not much we would be able to do. We would consider that undiagnosed hypertension, send you to your doctor and get everything checked out to make sure it’s okay. Sometimes they won’t even treat you. They’ll check everything, say you’re good and send you back, but oftentimes if that number is high for us it will also be high for them, so they’ll start you on something to get your blood pressure back under control.”

For us at Atlantic Coast Aesthetics, as with all reputable cosmetic surgical facilities and surgeons, patient safety is our top priority. We also have to comply with federal, state and local regulations which govern what we can and cannot do and under what circumstances. A nervous preop patient with slightly elevated blood pressure is unlikely to be a problem, as Dr. Pane described above. However, we would rather err on the side of caution and safety than gamble with a patient’s safety. If you are unsure whether your blood pressure, or any other vital sign, is normal, we strongly recommend you consult with your regular healthcare professional and your cosmetic surgeon before scheduling any procedures. This will help increase the odds of getting an ideal outcome during and after your procedure, and minimize the risk of having to cancel at the last minute.

If you have a question or concern about any aspect of cosmetic or plastic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics are always ready with straight talk and honest answers, so you can get the right information to help you decide what the best course of action is on your cosmetic surgery journey. Simply click here to contact us through our office email; follow us on Twitter, Facebook, Instagram and/or LinkedIn; or call us at (561) 422-4116. Your question could even be selected as the focus of an upcoming Ask Dr. Pane segment, allowing us to educate and help other patients who share your interests. Remember, at Atlantic Coast Aesthetics, we believe the only bad question is the one you DON’T ask!