Why the study?
Uncertainty remains regarding intraoperative blood pressure targets and perioperative management of long-term antihypertensive medications to prevent vascular complications in noncardiac surgery.
Does a hypotension-avoidance strategy reduce major vascular complications compared to a hypertension-avoidance strategy in patients having noncardiac surgery on long-term antihypertensive medications?
Population
7490 noncardiac surgery patients at risk for vascular complications receiving long-term antihypertensive medications
Comparison
Hypotension-avoidance strategy vs hypertension-avoidance strategy
Design
Multicenter partial factorial randomized trial with masked outcome adjudication
Follow-up
30 days
Authors
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Neither strategy reduces major vascular complications more than the other in noncardiac surgery; confirms similar perioperative safety of both BP approaches.
Does a hypotension-avoidance strategy reduce major vascular complications compared to a hypertension-avoidance strategy in patients having noncardiac surgery on long-term antihypertensive medications?
In patients undergoing noncardiac surgery, a hypotension-avoidance strategy (higher intraoperative blood pressure target and withholding antihypertensives) did not significantly reduce major vascular complications compared to a hypertension-avoidance strategy.
Marcucci et al. (2023) studied this question.
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