Study of Preoperative Management of Angiotensin Converting Enzyme Inhibitor (ACEi) and Angiotensin Receptor Blocker (ARB) Medications

Pre-Operative Inhibition of the Angiotensin System Study: A Prospective Randomized Single-Blinded Trial of Pre-Operative Management of Medications That Inhibit the Renin-Angiotensin System

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01091961

Acronym

PASS

Enrollment

200

Registered

2010-03-24

Start date

2010-01-31

Completion date

2011-12-31

Last updated

2021-10-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypertension

Keywords

ACE inhibitor, ARB, Non-cardiac surgery, Perioperative, Preoperative, Hypotension, Congestive heart failure, Hypertension, Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Type 1 Receptor Blockers, Perioperative Care

Brief summary

Patients on a stable dose of ACE inhibitor or ARB medication who are scheduled for elective surgery will be randomized to take their ACE inhibitor or ARB up to and including the morning of surgery, or to hold them a day prior to the surgery. The patients will be followed for 30 days after surgery to assess any adverse health outcomes.

Interventions

PROCEDUREPreoperative ACEi/ARB management

Patients will either hold their chronic ACEi/ARB medication for at least 24 hours prior to surgery, or continue to take the ACEi/ARB medication up to and including the day of surgery

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

DOUBLE (Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* currently taking an ACEi, ARB or both * no change in these medications during the two weeks prior to study enrollment * scheduled for non-cardiac surgery requiring regional or general anesthesia * minimum overnight anticipated length of stay * age ≥18 years.

Exclusion criteria

* explicit instructions provided to patient by surgical team regarding the perioperative management of ACEi or ARB * significant hypertension in pre-operative assessment clinic (systolic blood pressure ≥180 mmHg OR diastolic blood pressure ≥110 mmHg) * significant hypotension in pre-operative assessment clinic (systolic blood pressure \< 90 mmHg) * prior enrollment in the study * participation in another research study of antihypertensive medications

Design outcomes

Primary

Measure	Time frame
Mean arterial blood pressure	24 hours after surgery

Secondary

Measure	Time frame
Clinically significant hypotension	30 days after surgery
Clinically significant hypertension	30 days after surgery
All-cause mortality	30 days after surgery
Cardiovascular morbidity	30 days after surgery

Countries

Canada

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026