Should we treat hypertension immediately before electroconvulsive therapy?

Abstract

A 70-year-old man admitted with refractory major depression is scheduled for electroconvulsive therapy (ECT). He has hypertension and coronary artery disease, s/p myocardial infarction (MI), and stent 10 years ago. His cardiologist writes that he is stable on medications (lisinopril, aspirin, and escitalopram). He is thin, with a normal airway. Blood tests are within normal limits, and electrocardiogram (ECG) shows sinus rhythm with old Q-waves in inferior leads.