• undergoing major noncardiac surgery in general anesthesia will be included. Major noncardiac surgery is defined as:

‣ vascular surgery (with the exception of arteriovenous shunt, vein stripping procedures and carotid endarterectomies)

⁃ intraperitoneal surgery

⁃ intrathoracic surgery

⁃ major orthopedic surgery

• at cardiovascular risk, defined as meeting at least 1 of the following 6 criteria:

‣ preoperative NT-proBNP ≥ 200 ng/l

⁃ history of coronary artery disease

⁃ history of peripheral vascular disease

⁃ history of stroke

⁃ undergoing major vascular surgery, with the exception of arteriovenous shunt, vein stripping procedures and carotid endarterectomies

⁃ fulfillment of any 3 of the 8 following criteria:

• undergoing major surgery (intrathoracic, intraperitoneal or suprainguinal vascular surgery)

∙ any history of CHF or history of pulmonary edema

∙ anamnestic transient ischemic attack (TIA)

∙ diabetes under treatment with either oral antidiabetic agent or insulin

∙ age \> 70 years

∙ history of hypertension

∙ serum creatinine \> 175 mcmol/l or calculated creatinine clearance \< 60 l/min/1.73m2 (Cockroft Gault)

∙ history of smoking within 2 years of surgery

• intraoperative continuous invasive blood pressure monitoring indicated due to anesthetic or surgical factors

• planned surgical time ≥ 90 minutes

• planned postoperative hospital stay at least 1 night

⁃ Additional inclusion criteria for neurologic injury sub-study:

• Age ≥ 65 years