Which cardiovascular issue is associated with an increased risk of adverse events during noncardiac surgery?

Congestive heart failure is recognized as a significant risk factor for adverse cardiovascular events during noncardiac surgery. This condition indicates that the heart is unable to pump blood effectively, which can lead to reduced perfusion of vital organs and increased susceptibility to ischemia during the stress of surgery. Patients with congestive heart failure may have underlying issues such as fluid overload, decreased cardiac output, and potential arrhythmias, all of which can be exacerbated by the physiological stress of surgery, anesthesia, and postoperative recovery.

Moreover, tools like the American College of Cardiology/American Heart Association (ACC/AHA) guidelines define specific cardiovascular risk stratifications that prioritize patients with heart failure for additional preoperative evaluation and optimization. This focus is due to their heightened risk profile, particularly in terms of cardiopulmonary complications, heart attacks, and even mortality.

In contrast, while hypertension, diabetes mellitus, and cerebrovascular disease can also contribute to perioperative risk, their impacts are often more indirect or manageable with proper preoperative control and monitoring. Hypertension, for instance, generally requires consistent management rather than immediate surgical modifications, and enhanced glycemic control can mitigate many of the risks associated with diabetes. Cerebrovascular disease does carry significant implications, but it typically