General Principles

• Antihypertensive agents that the patient has taken prior to admission for surgery may have an impact on the perioperative period.
  • When the patient is receiving β-blockers or clonidine chronically, withdrawal of these medications may result in tachycardia and rebound hypertension, respectively.
  • Evidence suggests that holding angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the day of surgery may reduce perioperative hypotension.¹ These agents should not be held if given for HFrEF.