PeRsonalized Blood prEssure Management on Postoperative Complications and Mortality in hIgh-risk Patients Undergoing Major Non-cardiac Surgery

Inclusion Criteria: * Aged 65-90 yr; * Scheduled to undergo elective non-cardiac major surgery under general anesthesia (with an estimated surgery duration of ≥ 2 hours and an anticipated postoperative hospital stay of ≥ 2 days); * Patients with high cardiovascular risk, meeting at least one of the following conditions: 1. History of stroke; 2. History of coronary artery disease; 3. History of congestive heart failure; 4. History of peripheral arterial disease; 5. Preoperative brain natriuretic peptide (BNP) ≥ 92 mg/L or N-terminal pro-brain natriuretic peptide (NT-proBNP) ≥ 300 ng/L; 6. Preoperative cardiac troponin (cTn) or high-sensitivity cardiac troponin (hs-cTn) \> upper reference limit; 7. Hypertension requiring medication treatment; 8. Diabetes requiring medication treatment; 9. History of chronic kidney disease; 10. Continuous smoking for 2 years or more, with interruptions of less than one month before the current hospital admission; 11. Hypercholesterolemia; 12. History of transient ischemic attack. Exclusion Criteria: * Refuse to participate this trial; * Inability to communicate in the preoperative period because of coma, profound dementia, or language barrier; * Severe uncontrolled hypertension before surgery (systolic blood pressure ≥ 180 mmHg, diastolic blood pressure ≥ 110 mmHg); * Severe hepatic dysfunction (Child-Pugh Class C); or severe renal dysfunction required preoperative dialysis; or American Society of Anesthesiologists (ASA) physical status ≥ V; or expectation lifespan ≤ 24h; * Unstable cardiovascular conditions: acute coronary syndrome, decompensated heart failure, severe arrhythmias, severe valvular heart disease; * Scheduled to undergo neurosurgical procedures, transplantation, vascular surgery; * Urgent surgery; * Diagnosed with sepsis or sepsis shock before surgery. * Requiring vasopressor treatment before surgery. * Unable to finish 24-hour automated blood pressure monitor; * Current participation in another interventional study. * Any condition deemed ineligible for participation by clinicians.