Clinical management of stopping or continuing perioperative angiotensin II converting enzyme inhibitors and/or angiotensin receptor blockers: a survey of clinical opinion

Introduction: Concerns surrounding the perioperative administration of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), particularly the risk of unstable blood pressure, pose challenges for doctors. Decisions regarding the continuation or discontinuation of these medications lack objectivity, often operating in the absence of clear guidelines. We undertook a national survey of practice to understand clinicians’ viewpoints, perceived barriers regarding the use of ACE inhibitors and ARBs in the perioperative setting, and to contrast theoretical considerations with actual clinical practice, to inform the design of a multicentre clinical effectiveness trial of ACE inhibitors/ARBs.