An estimated 14 million inpatient and 19 million ambulatory operations are performed annually in the US, with many patients having cardiovascular risk factors/cardiovascular disease.

Preoperative initiation of statin therapies recommended for all patients with established to elevated atherosclerotic, cardiovascular disease risk, with intention for long-term use.

For patients with prior percutaneous coronary intervention undergoing non-cardiac surgery, continuation of aspirin is recommended.

For patients with coronary or disease without prior PCI, preoperative initiation of is aspirin is not recommended to the lack of benefit.

For patients taking stable doses of beta blockers, continuation of therapies based on clinical circumstances is recommended.

Initiation of beta blockers on the day of surgery and patients without clinical need is not recommended due to increase risk of postoperative mortality.

The sodium glucose co-transporter 2 inhibitors should be discontinued three days prior to surgery to reduce the risk of perioperative metabolic acid dosis.

GLP-1 agonist should be held more than one week prior to non-cardiac surgery and daily dose GLP-one agonist should be withheld one day prior to non-cardiac surgery due to the increased risk of pulmonary aspiration from gastroparesis.