Resuming treatment with angiotensin receptor blockers (ARBs) within two days following surgery is associated with reduced mortality rates in the first month post-surgery, reports a new study in the journal Anesthesiology.
Susan Lee, MD, of the University of California, San Francisco, and colleagues evaluated over 30,000 patients who were regularly taking ARB medication prior to surgery and were admitted from 1999–2011 to the Veterans Affairs Healthcare system for non-cardiac surgery. Nearly one-third of the patients did not have their ARB medication resumed within two days of their operation, which was associated with a 50% increased mortality rate within 30 days of surgery compared to those whose medication had been promptly resumed. The effect was greater in patients <60 years of age. Rates of infection, pneumonia, heart failure, and kidney failure were also lower in patients whose ARB medications were resumed soon after surgery, which could indicate that early resumption may also lower the risk of complications after surgery.
The authors stated that if doctors are concerned that ARB medication may cause dangerously low blood pressure or disrupt kidney function, they may continue to withhold the medication; however, they should be aware of the increased mortality rate that remained even after accounting for these complications in the first two days following surgery.
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