Preoperative Blood Pressure Strategies Yield Similar Postoperative Cognitive Results

Follow Drugslib on

Medically reviewed by Carmen Pope, BPharm. Last updated on June 6, 2025.

By Elana Gotkine HealthDay Reporter

FRIDAY, June 6, 2025 -- For patients undergoing noncardiac surgery, neurocognitive outcomes do not differ with hypotension-avoidance and hypertension-avoidance strategies, according to a study published online June 3 in the Annals of Internal Medicine.

Maura Marcucci, M.D., from Population Health Research Institute in Hamilton, Ontario, Canada, and colleagues compared the effects of perioperative hypotension-avoidance versus hypertension-avoidance strategies on delirium and cognitive decline after noncardiac surgery in a study involving 2,603 high vascular-risk patients receiving one or more chronic antihypertensive medications. The intraoperative mean arterial pressure (MAP) target was 80 mm Hg or greater in the hypotension-avoidance strategy group compared with 60 mm Hg or greater in the hypertension-avoidance strategy group (1,301 and 1,293 patients, respectively).

The researchers found that 7.3 and 7.0 percent of patients in the hypotension-avoidance and hypertension-avoidance groups had delirium on postoperative days 1 to 3, respectively (relative risk, 1.04; 95 percent confidence interval, 0.79 to 1.38). Among 701 patients who completed the Montreal Cognitive Assessment one year after surgery, 37.2 and 33.1 percent in the hypotension-avoidance and hypertension-avoidance groups had a decline of 2 or more points, respectively (relative risk, 1.13; 95 percent confidence interval, 0.92 to 1.38). Hypotension requiring an intervention occurred in 19 and 27 percent of patients in the hypotension-avoidance and hypertension-avoidance groups, respectively (relative risk, 0.63; 95 percent confidence interval, 0.52 to 0.76), mostly intraoperatively; in both groups, only 5 percent had hypotension postoperatively.

"Our findings do not support targeting an intraoperative MAP of 80 mm Hg or greater, compared with a MAP of 60 mm Hg or greater," the authors write.

Several authors disclosed ties to the medical technology or pharmaceutical industries.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

Source: HealthDay

Posted : 2025-06-07 06:00

Read more

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Popular Keywords