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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The effect of perioperative antihypertensive drugs on mortality and physical function in non-cardiac surgeries remains unclear. We aimed to clarify the association between six antihypertensive classes and postoperative outcomes in hypertensive patients.
We conducted a retrospective cohort study using a nationwide administrative claims database. Adults aged ≥50 years who underwent one of five types of non-cardiac surgeries between 2014 and 2019 were included. A total of 408,810 patients who consistently used antihypertensive medications before and after surgery were analyzed to compare outcomes across different treatment regimens. The risk for overall death or functional decline, defined as a ≥20% decrease in Barthel Index score during hospitalization, was determined using multivariable logistic regression models.
All-cause deaths or functional decline occurred in 4,228 (1.0%) or 20,625 (5.0%) patients, respectively. Among single-class users, angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) showed a multivariable odds ratio (OR) of 0.74 [95% confidence interval (CI) 0.62–0.89 vs. thiazide/thiazide-like diuretics (TH)] for the composite of mortality and functional decline. Among recipients of two medication classes, calcium receptor blockers (CCBs)/ACEi or ARB usage was associated with the lowest risk for composite outcome (OR 0.86, 95% CI 0.81-0.91 vs. TH/CCBs). The combinations of the ≥3 classes, including TH/CCB/ACEi or ARB, displayed the lowest odds for the composite outcome. Figure illustrates the Kaplan-Meier curves for the unadjusted cumulative incidence of in-hospital death within 120 postoperative days (PODs) across different antihypertensive medication groups. Minimal differences were observed between thiazide users and non-users (adjusted HR 1.08; 95% CI, 0.93–1.26). In contrast, ACEi/ARB use was associated with a significantly lower risk of in-hospital death compared to non-use, with survival differences continuing to widen beyond 30 PODs (adjusted HR 0.74; 95% CI, 0.68–0.80). Among various types of non-cardiac surgery, orthopaedic procedures and gastrointestinal resection were particularly associated with better survival and physical function when ACEis or ARBs were used. The association between ACEi or ARB use and reduced postoperative risk remained consistent across subgroups stratified by age, sex, preoperative comorbidities, hyperkalaemia, statin use, antiplatelet medication use, perioperative intravenous vasopressor use, and red blood cell transfusion. A significant interaction was observed with statin therapy: patients receiving both ACEi/ARB and statins had the lowest risk of mortality and functional decline compared to those receiving neither (OR 0.78, 95% CI 0.75–0.82).
Perioperative use of ACEis or ARBs is associated with favorable outcomes in patients undergoing non-cardiac surgeries. A pharmacological strategy centered on ACEi or ARB therapy, particularly when combined with statin use, may enhance postoperative outcomes. These findings underscore the importance of optimized "perioperative medicine" through pharmacologic management and suggest a potential role for "perioperative nephrology" in guiding perioperative cardiovascular and renal risk management.
