Circulatory stability is one of the main objectives of the perioperative management of high-risk patients. Most of these patients are chronically treated with cardiovascular treatments, which interfere with the functioning of several physiological systems aimed at maintaining the circulatory status when the loading conditions of the heart deteriorate, or limit the compensatory mechanisms used when metabolic needs increase. Taking into account the pharmacology of these medications, their repercussions on perioperative haemodynamics and their potential beneficial effects on regional circulations, it has become possible to determine whether or not they must be given or withdrawn perioperatively.