Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Feb 25.
doi: 10.1007/s12630-026-03074-x. Online ahead of print.

More than meets the "I": the complex decision to withhold or continue renin-angiotensin-aldosterone system inhibitors before surgery

Michael A Smith  1
Affiliations

More than meets the "I": the complex decision to withhold or continue renin-angiotensin-aldosterone system inhibitors before surgery

Michael A Smith. Can J Anaesth. .
No abstract available

Keywords: intraoperative hypotension; myocardial injury; noncardiac surgery; perioperative care; renin–angiotensin–aldosterone system inhibitors.

PubMed Disclaimer

References

    1. Duceppe E, Parlow J, MacDonald P, et al. Canadian Cardiovascular Society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery. Can J Cardiol 2017; 33: 17–32. https://doi.org/10.1016/j.cjca.2016.09.008 - DOI - PubMed
    1. Halvorsen S, Mehilli J, Cassese S, et al. 2022 ESC guidelines on cardiovascular assessment and management of patients undergoing noncardiac surgery: developed by the task force for cardiovascular assessment and management of patients undergoing noncardiac surgery of the European Society of Cardiology (ESC); endorsed by the European Society of Anaesthesiology and Intensive Care (ESAIC). Eur Heart J 2022; 43: 3826–924. https://doi.org/10.1093/eurheartj/ehac270 - DOI - PubMed
    1. Thompson A, Fleischmann KE, Smilowitz NR, et al. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2024; 150: e351–442. https://doi.org/10.1161/CIR.0000000000001285 - DOI - PubMed
    1. Shiffermiller JF, Monson BJ, Vokoun CW, Erwin PJ, LaBella M, Montori VM. Prospective randomized evaluation of preoperative angiotensin-converting enzyme inhibition (PREOP-ACEI). J Hosp Med 2018; 13: 661–7. https://doi.org/10.12788/jhm.3036 - DOI - PubMed
    1. Rosenman DJ, McDonald FS, Ebbert JO, Erwin PJ, LaBella M, Montori VM. Clinical consequences of withholding versus administering renin-angiotensin-aldosterone system antagonists in the preoperative period. J Hosp Med 2008; 3: 319–25. https://doi.org/10.1002/jhm.323 - DOI - PubMed

LinkOut - more resources