Hypertension is defined as values >140mmHg for systolic and/or >90mmHg for diastolic. It is essential to perform endodontic procedure with control of pain and anxiety to avoid triggering acute complications. Interaction of local anesthesia (LA) with nonselective beta-blockers may increase LA toxicity. The cardiovascular effects of epinephrine may be potentiated by the use of medications such as nonselective beta-blockers (propranolol and nadolol). Guidelines recommend decreasing the dose and increasing the time interval between epinephrine injections. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) may antagonize the antihypertensive effect of diuretics, beta-blockers, alpha-blockers, vasodilators, and angiotensin-converting enzyme inhibitors. The short-term administration has, however, a clinically meaningful effect, and paracetamol can be used to avoid this side effect.
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