Comparison of cardiovascular response between patients on warfarin and hypertensive patients not on warfarin during dental extraction

Objective To evaluate cardiovascular response in patients on warfarin and hypertensive patients not on warfarin during dental extraction. Materials and methods This retrospective study included 53 patients who had undergone dental extraction while on warfarin (mean age 78.8 +/- 6.3 years, 26 men) and 66 with hypertension who had undergone dental extraction but were not on warfarin (mean age 77.4 +/- 6.8 years, 22 men). Vital signs were monitored in both groups during extraction. Results The highest systolic blood pressure (SBP) values (mean 150.1 +/- 21.1 mmHg) were observed in patients on warfarin before (9.0%) and after (10.3%) administration of local anesthesia (LA), during extraction (39.7%), and during (33.3%) and after (7.7%) suturing (n= 78;p< 0.01), and in hypertensive patients not receiving warfarin (160.6 +/- 24.8 mmHg) before (19.2%) and after (27.3%) administration of LA, during extraction (29.3%), and during (18.2%) and after (6.1%) suturing (n= 99;p< 0.01). The highest SBP was linearly correlated with SBP before administration of LA in patients on warfarin (highest SBP = 0.9415 x SBP before LA + 23.243,R-2= 0.75481) and in hypertensive patients not on warfarin (highest SBP = 1.0027 x SBP before LA + 15.789,R-2= 0.60341). Conclusions The highest SBP was not distributed evenly between patients on warfarin and hypertensive patients not on warfarin during dental extraction and was strongly associated with SBP before LA regardless of anticoagulant status.