{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:43:31Z","timestamp":1790876611691,"version":"4.1.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health and Labour Sciences Research Grant","award":["Seisaku-Sitei-24AA2006"],"award-info":[{"award-number":["Seisaku-Sitei-24AA2006"]}]},{"name":"Japan Ministry of Health, Labour and Welfare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The association between perioperative antihypertensive drugs and mortality as well as physical function in non-cardiac surgeries remains unclear. We aimed to clarify the association between six antihypertensive classes and postoperative outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This observational cohort study involved adults undergoing non-cardiac surgeries between 2014 and 2019 using an administrative claims database. We recruited 408 810 patients who continuously used any class of antihypertensive medication both pre- and postoperatively and 2 190 064 non-continuous users aged \u226550 years who underwent five different types of non-cardiac surgeries. The risk for overall death or functional decline, defined as a \u226520% decrease in the Barthel Index score during hospitalization, was determined using multivariable logistic regression models. All-cause deaths or functional decline occurred in 4228 (1.0%) users and 17 978 (0.8%) non-users or 20 625 (5.0%) users and 66 218 (3.0%) non-users, respectively. Among single-class users, angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) showed a multivariable odds ratio (OR) of 0.74 [95% confidence interval (CI) 0.62\u20130.89 vs. thiazide\/thiazide-like diuretics (TH)] for the composite of mortality and functional decline. Among recipients of two medication classes, calcium receptor blockers (CCBs)\/ACEi or ARB usage was associated with the lowest risk for composite outcome (OR, 0.86; 95% CI, 0.81\u20130.91 vs. TH\/CCBs). The combinations of the \u22653 classes, including TH\/CCB\/ACEi or ARB, displayed the lowest odds for the composite outcome. In orthopaedic surgery and gastrointestinal resection, ACEis or ARBs were associated with better survival and physical function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Perioperative use of ACEis or ARBs is associated with favourable outcomes in non-cardiac surgeries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeaf096","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T22:49:22Z","timestamp":1755038962000},"source":"Crossref","is-referenced-by-count":3,"title":["Perioperative antihypertensive medications and effects on functional decline and mortality in non-cardiac surgery"],"prefix":"10.1093","volume":"5","author":[{"given":"Rena","family":"Suzukawa","sequence":"first","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6709-306X","authenticated-orcid":false,"given":"Shintaro","family":"Mandai","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Inaba","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisazumi","family":"Matsuki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayasu","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Susa","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Iimori","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisei","family":"Sohara","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatemitsu","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Dokkyo Medical University , Tochigi 321-0293 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo 113-8519 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of 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