Background
Although hypertension requiring medica5on (HTNm) is a well-known cardiovascular
comorbidity, its associa5on with postopera5ve outcomes is understudied. This study aimed to
evaluate whether preopera5ve HTNm is independently associated with specific complica5ons
aCer pancrea5coduodenectomy.
Study Design
Adults undergoing elec5ve pancrea5coduodenectomy were included from the 2014–2019
NSQIP-targeted pancreatectomy dataset. Mul5variable regression models compared outcomes
between pa5ents with and without HTNm. Endpoints included significant complica5ons, any
complica5on, unplanned readmissions, length of stay (LOS), clinically relevant postopera5ve
pancrea5c fistula (CR-POPF), and cardiovascular and renal complica5ons. A subgroup analysis
excluded pa5ents with diabetes, heart failure, chronic obstruc5ve pulmonary disease, es5mated
glomerular filtra5on rate from serum crea5nine (eGFRCr) < 60 ml/min per 1.73m 2 , bleeding
disorder, or steroid use.
Results
Among 14,806 pa5ents, 52% had HTNm. HTNm was more common among older male pa5ents
with obesity, diabetes, conges5ve heart failure, chronic obstruc5ve pulmonary disease,
func5onal dependency, hard pancrea5c glands, and cancer. ACer adjus5ng for demographics,
preopera5ve comorbidi5es, and laboratory values, HTNm was independently associated with
higher odds of significant complica5ons (aOR 1.12, p = 0.020), any complica5on (aOR 1.11, p =
0.030), cardiovascular (aOR 1.78, p = 0.002) and renal (aOR 1.60, p = 0.020) complica5ons, and
unplanned readmissions (aOR 1.14, p = 0.040). In a subgroup analysis of pa5ents without major
preopera5ve comorbidity, HTNm remained associated with higher odds of significant
complica5ons (aOR 1.14, p = 0.030) and cardiovascular complica5ons (aOR 1.76, p = 0.033).
Conclusions
HTNm is independently associated with cardiovascular and renal complica5ons aCer
pancrea5coduodenectomy and may need to be considered in preopera5ve risk stra5fica5on.
Future studies are necessary to explore associa5ons among underlying hypertension, specific
an5hypertensive medica5ons, and postopera5ve outcomes to inves5gate poten5al risk
mi5ga5on strategies.