Reviewed by Dr. Bernard Ashby, MD, MPP, FACC — quadruple board-certified vascular cardiologist and founder of Preop Doc.
Good cardiovascular health doesn't just support a smoother surgery — it's one of the most controllable factors in reducing your surgical risk. Here's what the evidence actually supports, explained plainly. (See our companion post on why cardiac clearance matters for the full evaluation picture.)
If You Smoke, Timing Matters
Quitting smoking 4–8 weeks before surgery is associated with roughly half the rate of wound-related complications compared to continuing to smoke, according to a Cochrane systematic review of smoking-cessation interventions timed around surgery. The earlier you quit, the better — but even quitting the day before surgery still carries some benefit. It's never "too late" to matter.
Blood Pressure — What Your Care Team Is Actually Looking For
There's no single hard cutoff that automatically postpones surgery. A commonly referenced threshold is a systolic reading at or above 180, or diastolic at or above 110, as grounds to consider delaying an elective procedure, with a general pre-op goal closer to 140/90. In practice, your care team weighs blood pressure alongside your age, other conditions, and how urgent the surgery is — not in isolation.
Blood Sugar Control for Diabetic Patients
Guidelines generally recommend checking HbA1c within three months of surgery, though exact targets vary between medical societies rather than following one universal number. A reasonable day-of-surgery target for blood glucose is 100–180 mg/dL. As with blood pressure, your surgical team and Preop Doc will determine the right target for your specific situation.
Know Your Medications
Never stop or start a blood thinner, insulin, or beta-blocker on your own ahead of surgery. A proper medication review — done as part of your clearance evaluation — is one of the most important and most overlooked steps in surgical preparation.
The Two-Flight-of-Stairs Test
One of the simplest, most evidence-backed self-checks of surgical readiness is functional capacity: can you climb two flights of stairs without stopping? It's a genuinely useful proxy that clinicians rely on alongside more formal assessments.
The Bottom Line
None of this requires a dramatic life overhaul in the weeks before surgery — just focused attention on the factors that actually move the needle. Ready to get evaluated? Schedule a referral with Preop Doc.
