Cardiovascular pharmacotherapeutic considerations in patients undergoing anesthesia

Demographic shifts toward an increasingly older population have resulted in a high prevalence of persons taking cardiovascular medication. Many patients on cardiovascular medications will require surgical intervention for conditions often unrelated to their cardiovascular pathology. Cardiologists and anesthesiologists alike must be knowledgeable about the potential interactions between cardiovascular drugs and anesthetics agents or adjuvant therapies administered perioperatively. Current recommendations suggest that beta blockers, calcium channel blockers, amiodarone, and alpha2 agonists should be continued throughout the perioperative period, whereas angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and diuretics should be discontinued on the morning of surgery and resumed in the immediate postoperative period, unless contraindicated.