Causes of Hypertension After Surgery

For patients who typically have blood pressure that is in the normal range, it can be very alarming to see high blood pressure readings during the recovery period after surgery.

Woman wearing blood pressure gauge
Joseph Rene Briscoe / Getty Images

While this can be alarming, be aware that changes in blood pressure—often high readings but sometimes low—are not uncommon after having surgery.

The reasons for these changes may have everything to do with surgery, or the instructions you were given prior to surgery, but in some cases have little or nothing to do with the procedure.

Pain and High Blood Pressure 

Pain is one of the easiest ways to increase your blood pressure, and experiencing pain is quite common after many surgeries.

While severe pain is not common after surgery, it would be normal to have a higher blood pressure when experiencing moderate to severe pain than when pain-free. For some individuals, even minor pain can lead to elevated blood pressure readings.

Your increased blood pressure may be the result of the fact that it is painful to sit in the waiting room of your healthcare provider's office after surgery, or it may be painful for you to walk to the examination room before your blood pressure is taken.

Perhaps you experienced mild to moderate pain most of the day during your first few days of recovery, which can certainly cause an increase in blood pressure.

Other Causes 

Not in pain? There are other reasons why your blood pressure could be increased after surgery. Most people feel like they have extra fluid in their body after surgery, which may show up as edema (swelling) in the hands, feet, and legs.

Were you asked to skip your blood pressure medications the morning of surgery? Did you miss any doses during your recovery or have your dosages been changed? That will also change your level of control over your blood pressure.

Having a salty meal or radically changing your diet can also make noticeable changes in your blood pressure and some medications increase blood pressure.

Primary Hypertension

Stage 1 hypertension is defined as blood pressure that is 130-109/80-89; stage 2 is greater than 140/90. Primary hypertension means that an unrelated disease or problem is not responsible for the problem. For example, someone with kidney disease that causes high blood pressure does not have primary hypertension.

General Causes of Hypertension

  • Smoking
  • Too much dietary salt
  • Obesity/overweight
  • Family history of hypertension
  • Excess alcohol consumption
  • Pain
  • Stress—emotional and physical (i.e., surgery)

Secondary Hypertension

Secondary hypertension is high blood pressure that is caused by an unrelated condition in the body. That means that sickness, medication or even a disease process in your body is causing your blood pressure to be elevated.

Causes of Secondary Hypertension

  • Pregnancy: Preeclampsia and eclampsia
  • Kidney disease or kidney surgery
  • Coarctation of the aorta: Narrowing of the aorta (present from birth) that causes high blood pressure in the arms
  • Adrenal gland dysfunction: This is a gland that sits on top of the kidneys that, when malfunctioning, can lead to extremely high blood pressure.
  • Sleep disorders: Including sleep apnea
  • Thyroid disorders
  • Prescription medication: Including steroids and hormones
  • Over-the-counter medication: Including pain relievers and cold medicines
  • Illicit drugs: Cocaine, crystal meth, amphetamines
  • Caffeine

White Coat Hypertension

White coat hypertension is the term for high blood pressure that is elevated during medical visits but is normal at home.

Monitoring blood pressure at home or elsewhere outside of the clinical environment may provide more accurate readings in patients who have anxiety regarding medical care.

Some people who believe they have white coat hypertension actually have real hypertension, so testing blood pressure at home on a regular basis is important to determine your blood pressure reading.

Talk to Your Healthcare Provider

The cause of hypertension is not as important as making sure it either goes away on its own or you seek treatment. Hypertension can lead to a stroke and other serious complications. Many people do not have symptoms when they have high blood pressure, which is why it is called "a silent killer."

If you haven’t talked to your surgeon, they need to be made aware of this issue. Your primary care

Your primary healthcare provider can also be a source of guidance if it continues.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Meng L, Yu W, Wang T, Zhang L, Heerdt PM, Gelb AW. Blood pressure targets in perioperative care. Hypertension. 2018;72(4):806-817. doi:10.1161/HYPERTENSIONAHA.118.11688

  2. Saccò M, Meschi M, Regolisti G, et al. The relationship between blood pressure and pain. J Clin Hypertens (Greenwich). 2013;15(8):600-5. doi:10.1111/jch.12145

  3. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Physician. 2013;88(2):102-110.

  4. US National Library of Medicine Genetics Home Reference. Hypertension.

  5. Gupte S, Wagh G. Preeclampsia-eclampsiaJ Obstet Gynaecol India. 2014;64(1):4–13. doi:10.1007/s13224-014-0502-y

  6. Puar TH, Mok Y, Debajyoti R, Khoo J, How CH, Ng AK. Secondary hypertension in adults. Singapore Med J. 2016;57(5):228-32. doi:10.11622/smedj.2016087

  7. Aronow WS. Drug-induced causes of secondary hypertension. Ann Transl Med. 2017;5(17):349. doi:10.21037/atm.2017.06.16

  8. Cobos B, Haskard-zolnierek K, Howard K. White coat hypertension: improving the patient-health care practitioner relationship. Psychol Res Behav Manag. 2015;8:133-41. doi:10.2147/PRBM.S61192

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.