Adherence to medication intake instructions before surgery in patients taking renin-angiotensin system inhibitors: a prespecified substudy of the AIPOP trial

This article addresses adherence to medication intake instructions before surgery in patients taking renin-angiotensin system inhibitors (RASIs). Recent randomized controlled trials (RCTs) investigated whether these medications should be continued or discontinued before major elective noncardiac surgery. A meta-analysis of these studies showed no difference in the incidence of cardiovascular complications, acute kidney injury, or death. This applied to both patients who continued taking RASIs and those who withheld them before surgery. An important issue in this context is adherence to chronic cardiovascular medications such as RASIs. When implementing the results of these trials into clinical practice, it should be noted that adherence to antihypertensive drugs is generally poor. Specifically, the adherence rate is only 45%.