Medications
Blood Pressure Medicines Before Surgery
Blood pressure medicines aren't one-size-fits-all before surgery — some are taken as usual, and a few are commonly held the morning of.
Quick answer
Why it matters
Anesthesia naturally lowers blood pressure. ACE inhibitors, ARBs and diuretics can add to that and cause very low pressure during surgery, so they're often skipped the morning of.
Beta-blockers are different — stopping them abruptly can cause a rebound rise in heart rate and blood pressure and is risky, so they're usually continued right through.
Do not stop without instruction
What to ask your doctor
- Which of my BP medicines do I take on the morning of surgery, and which do I hold?
- Is any of mine an ACE inhibitor, ARB, or diuretic?
- Should I continue my beta-blocker as usual?
- What should I do if my blood pressure is very high that morning?
Red flags — call your team
Red flags — call your team
- Chest pain or severe headache
- Blood pressure very high (e.g. above 180/110) on the day
- You take a beta-blocker and were told to stop it suddenly
References
- American College of Cardiology / American Heart Association (ACC/AHA) — perioperative cardiovascular guidelines. acc.org
- American Society of Anesthesiologists (ASA). asahq.org
Frequently asked questions
Should I take my blood pressure tablet on the morning of surgery?
Most are taken with a sip of water, but ACE inhibitors, ARBs and diuretics are often held that morning. Get a specific instruction for each of your medicines.
Can I stop my beta-blocker before surgery?
No — beta-blockers should not be stopped abruptly. They're usually continued through surgery.