Key result
Planned RCT tests if continuing vs withholding ACEIs/ARBs before non-cardiac surgery reduces major events.
Why the study?
It is debatable whether hypertensive patients presenting for non-cardiac surgery should continue or discontinue ACEIs/ARBs preoperatively due to balancing risks of hypotension versus rebound hypertension and myocardial ischaemia.
Does continuing versus withholding ACEIs/ARBs reduce the composite outcome of mortality and major adverse events in hypertensive patients undergoing elective non-cardiac surgery?
RCT (n=2,100)
Open-label
Permuted block randomization
Yes
Does continuing versus withholding ACEIs/ARBs reduce the composite outcome of mortality and major adverse events in hypertensive patients undergoing elective non-cardiac surgery?
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This study protocol describes a randomized trial to evaluate the safety and efficacy of continuing versus withholding ACE inhibitors or ARBs prior to elective non-cardiac surgery.
Misra et al. (2022) conducted an RCT in Hypertension in patients undergoing elective non-cardiac surgery (n=2,100). Continuing ACEIs/ARBs vs. Withholding ACEIs/ARBs 24-36 hours before surgery was evaluated on Composite of all-cause in-hospital/30-day mortality, major adverse cardiovascular events, acute kidney injury, postoperative respiratory failure, sepsis, and unplanned ICU admissions. This study protocol outlines a planned randomized controlled trial to determine if continuing versus withholding ACEIs/ARBs before non-cardiac surgery reduces 30-day mortality and major adverse events.
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