Introduction
The renin-angiotensin-aldosterone system (RAAS) antagonists include ACE inhibitors (ACEIs), angiotensin II receptor subtype 1 blockers (ARBs) and direct renin inhibitors (e.g. aliskiren). Their beneficial cardiovascular and renal effects made them key components in the therapeutic armamentarium of common diseases like hypertension[4], congestive heart failure[5], ischaemic heart disease[6] and diabetic nephropathy[7]. Therefore, most patients presenting for cardiac and non-cardiac surgery are on one or more of those drugs and the alterations they cause in cardiovascular physiology may be problematic in the perioperative setting.