JAMA Clinical Reviews
JAMA Highlights From ESC 2024
Sep 2, 2024
Kirsten Bibbins-Domingo, the Editor in Chief of JAMA, dives into groundbreaking trials from the ESC 2024 Congress. She discusses the impact of antihypertensive continuation before surgery and potassium's role post-cardiac surgery. A key highlight is a triple-drug combination pill aimed at tackling resistant hypertension in Africa, showing promise in improving patient outcomes. Lastly, Bibbins-Domingo emphasizes innovative methods to manage hypertension in Nigeria, pointing to a significant leap in treatment efficacy. This conversation is a treasure trove for cardiovascular health enthusiasts.
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Quick takeaways
- Continuing antihypertensive medications until surgery day does not significantly increase post-operative complications but may lead to intraoperative hypotension.
- A low-dose triple-drug combination pill significantly improves hypertension management in Nigeria, showcasing a need for better treatment strategies in sub-Saharan Africa.
Deep dives
Antihypertensive Medications and Elective Surgery
Research indicates that patients with hypertension undergoing elective major non-cardiac surgery may reasonably continue their antihypertensive medications until the day of the procedure. A multi-center trial compared the outcomes of patients who continued their ACE inhibitors or angiotensin receptor blockers to those who stopped them 48 hours prior. The trial found no significant difference in post-operative complications or all-cause mortality between the two groups, although those continuing medications experienced more prolonged intraoperative hypotension. These findings suggest the importance of monitoring patients for hypotension while considering the safe continuation of essential medications during surgery.
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