Hypertension and management of hypertensive patient in dentistry. Drug interaction and pre & postoperative consideration

Author(s): Bindu Bisht

Most of the times dentist plays the significant role in dignosing undetected hypertension in dental patient beside this Hypertensive drugs have oral manifestation and adverse effect on oral health .Many hypertensive drugs interaction causes serious life threatning complications. NSAID (aisprin and indomethacin in particular)reduce the antihypertensive effects of ACE inhibitors by blocking bradykinin mediated vasodilatation. NSAID inhibit the diuretic effects of thiazides and loop diuretics and antagonize the antihypertensive effect of β-Blockers . Use of guanethidine (an adrenergic neuron blocker and an antihypertensive drug ) on long term basis produces the sensivity to an exogenously administered epinephrine as present in local anaesthetic injection results in hypertension and cardiac arrhythmias.Non selective β-Blockers (propranolol) or mixed α and β-Blockers may rather enhance the pressure response to vasoconstrictor epinephrine resulting in hypertension