Why the study?
There has been ongoing debate regarding whether to continue or withhold ACE inhibitors or ARBs in patients undergoing noncardiac surgery.
Does continuation of ACE inhibitors or ARBs compared to discontinuation affect cardiovascular adverse events or intraoperative hypotension in patients undergoing noncardiac surgery?
Population
Patients on ACE inhibitors or ARBs undergoing noncardiac surgery
Comparison
Continuation vs discontinuation of ACE inhibitors or ARBs
Design
Review
Authors
Loading...
Either continuation or discontinuation of RASIs yields similar postoperative outcomes; supports individualized perioperative decisions in major noncardiac surgery.
Does continuation of ACE inhibitors or ARBs compared to discontinuation affect cardiovascular adverse events or intraoperative hypotension in patients undergoing noncardiac surgery?
While continuing ACE inhibitors or ARBs during noncardiac surgery does not increase major cardiovascular events, it increases intraoperative hypotension, supporting the ACC 2024 recommendation to withhold them 24 hours prior in elevated-risk surgery unless the patient has HFrEF.
Kallash et al. (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: