Antihypertensives in Non-cardiac Surgical Population

Study Overview
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Brief Summary
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A cohort of hypertension patients undergoing elective non-cardiac surgery was constructed to investigate current status of antihypertensive drug treatment in non-cardiac surgical population.

Detailed Description
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Perioperative changes in blood pressure (BP) are associated with perioperative risks. However, there is little information regarding the current status of antihypertensive treatment in non-cardiac surgical population. A cohort of 351 hypertension patients aged between 18 to 85-year old undergoing elective non-cardiac surgery was constructed to investigate the application of antihypertensive drugs, systemic involvement, perioperative hemodynamics and internal environment to grasp the perioperative impact of different antihypertensive drugs, and to further provide a reference for the preoperative antihypertensive strategy of surgery patients.

Official Title
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Current Status of Antihypertensive Drug Treatment in Non-cardiac Surgical Population

Conditions
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Perioperative Antihypertensive

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing elective non-cardiac surgery with hypertension(i.e., with a systolic blood pressure(SBP) of >=140 mmHg and/or a diastolic blood pressure(DBP) of >=90 mmHg based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) or self-reported use of antihypertensive medication Exclusion Criteria: Patients under the age of 18 years old Patients more than 85 years old Patients suspected of intracranial hypertension

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ARB<br>Group of angiotensin receptor blockers(ARB) monotherapy users. A subject was considered as an ARB user when the total prescription days of ARB monotherapy was at least 30. | |
| combination of CCB and ARB<br>Group of calcium channel blockers(CCB) and angiotensin receptor blockers(ARB) combination users. A subject was considered as a CCB and ARB combination user when the total prescription days of CCB and ARB combination therapy was at least 30. | |
| CCB<br>Group of calcium channel blockers(CCB) monotherapy users. A subject was considered as a CCB user when the total prescription days of CCB monotherapy was at least 30. | |
| No treatment<br>Group of nonusers of antihypertensives. A subject was considered as a nonuser never received regular antihypertensive treatment or total prescription days of antihypertensives was less than 30. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| perioperative blood press(BP) | baseline BP before the operation, when entering and exiting post-anesthesia care unit(PACU) | from the moment on arrival to the operating room until the moment leaving PACU, assessed up to 240 minutes. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pH, base excess, and concentration of HCO3- in blood gases | arterial blood gases detected by using the ABL800 (Radiometer Med Aps Ltd, Copenhagen, Denmark) | 5 minutes after extubating in PACU | 
| the incidence of hypotension in PACU | If there were more than two consecutive episodes of hypotension (which was defined as SBP less than 80% of baseline) a rescue intravenous bolus of 100 mg of phenylephrine was given. | from the moment on arrival to PACU until 60 minutes after arriving or the moment leaving PACU, whichever came first, assessed up to 240 minutes. | 
| the incidence of hypertension in PACU | the incidence of hypertension, which was defined as SBP greater than 120% of baseline | from the moment on arrival to PACU until 60 minutes after arriving or the moment leaving PACU, whichever came first, assessed up to 240 minutes. | 
| hospitalization days | The duration of this single episode of hospitalization | from the date of admission until the date of discharge or date of death from any cause, whichever came first, assessed up to 100 days |