Global study dispels benefits of blood pressure management during non-cardiac surgery

Editor's Note

A new global clinical trial indicates targeting higher blood pressure during non-cardiac surgeries is no better than current standard approach in preventing acute kidney injury, according to a November 5 report from London Health Sciences Centre.

With 300 million non-cardiac surgeries performed worldwide every year, risk of kidney damage is a major concern. According to the article, the POISE-3 trial compared two blood pressure management strategies—avoiding hypotension and preventing hypertension—in more than 7,000 patients from 110 centers across 22 countries. Published in Kidney International, the findings showed no significant difference in kidney injury risk between the two blood pressure strategies. This conclusion provides guidance to perioperative teams by suggesting that there is no clear optimal blood pressure target for kidney protection during surgery, researchers write. 

Additionally, the study emphasized the safety of continuing blood pressure medications throughout the perioperative period. Often, such medications, which can support long-term kidney health, are stopped preoperatively and not resumed at discharge. However, authors emphasize that such decisions should be made on a case-by-case basis.