After Surgery, Resuming This Rx Might Help Patients

Resuming blood pressure medication soon after surgery may improve survival

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) When going under the knife, many patients may stop taking their normal medications to prepare for surgery. Getting back on one common type of medication as soon as possible, however, may be better for patients' health.

A new study found that patients who resumed use of a prescription blood pressure drug soon after surgery were more likely to survive in the month after their procedures.

"Sometimes doctors briefly stop [angiotensin receptor blocker (ARB)] medications around the time of surgery because they are known to cause low blood pressure while under general anesthesia, which can be dangerous for the patient," explained lead author Susan M. Lee, MD, of the Department of Anesthesia and Perioperative Care at the University of California, San Francisco, in a news release.

ARBs (brand names like Atacand, Avapro and Diovan) are often used to treat high blood pressure. In high blood pressure, the blood pushes on artery walls with too much force. This can eventually cause damage and lead to problems like heart disease and stroke.

Dr. Lee and team looked at data from the Veteran Affairs Healthcare system to identify patients who were prescribed ARBs and underwent surgery between 1999 and 2011. The patients underwent surgery for a variety of reasons, but the procedures were all considered "noncardiac," or not related to the heart.

A total of 30,173 patients were identified. Around a third of the patients (33.8 percent) had not resumed use of their prescribed blood pressure medication by the second day after surgery. These patients were compared to the remaining 66.2 percent of patients who had resumed using ARBs by day two.

Dr. Lee and team found that 30 days after surgery, only 1.3 percent of the patients who quickly went back on ARBs had died — compared to 3.2 percent of the other group.

While death rates for both groups were low, the risk of dying during the month following surgery was more than twice as high among those who did not resume use of blood pressure medication quickly.

The risk of death was higher in younger patients (under age 60) than in older patients (above age 75), Dr. Lee and colleagues found.

"Our study highlights the importance of resuming medications that patients were previously taking at home as soon as it is feasible after surgery," Dr. Lee said.

This study involved mostly men. Further research involving more diverse participants is needed to better understand how blood pressure drugs should be used after surgery, Dr. Lee and team said. Patients should speak with a doctor about what drugs are safe after surgery.

This study was published online June 4 in the journal Anesthesiology.

Study authors worked for a number of groups that funded this research. These included the University of California, San Francisco, and various Veterans Affairs offices.

Review Date: 
June 2, 2015
Last Updated:
June 8, 2015