الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cases presented by immediate preoperative high blood pressure represent a challenge for anesthesia as the prevalence of hypertension in Egypt is unusually high (30.4%) for a developing country (15) especially among elderly subjects (65-71 years). The importance of immediate preoperative hypertension has not been clearly established by adequate trials and investigations. Several clinical trials have been conducted to improve outcome and to study whether cardioprotective medical therapies, including β- blockers and α-2 adrenergic agonists, are associated with risk reduction. We conducted this meta-analysis which included recently published randomized control trails, to investigate cardioprotective effect of perioperative β – blockers and perioperative α-2 agonists namely hard cardiac endpoints; postoperative mortality, myocardial infraction, myocardial ischaemia and occurrence of arrhythmia. The results of our meta-analysis indicated that β blockers protects against myocardial ischaemia in first 3 postoperative days. Bradycardia in patients relieving β blockers seems to contribute to its cardio-protective effect. α 2- agonist, though not familiar in clinical practice , decreases mortality and protects against myocardial ischaemia in first 3 postoperative days. Implementation of protocols to regulate the use of cardioprotective drugs and limit its under use is recommended to improve clinical outcome of patient with high cardiac risk index.