Target blood pressure in the ICU

Maria Lorenza Muiesan, MD, is a professor of internal medicine at the University of Brescia, Italy. Her research focuses on cardiovascular abnormalities and use of cardiovascular drugs in hypertension and heart failure.

In your opinion, while treating hypertension, what target blood pressure values could be reasonable to aim for in the intensive care unit (ICU)? Can we generalize?

Maria Lorenza Muiesan, MD: No, we cannot generalize, because clinical pictures of hypertensive emergencies are quite different from each other. For example, in acute aortic syndrome the target blood pressure to be reached for systolic blood pressure is <120 mm Hg or even lower, if tolerated, and heart rate should be at the same time reduced <60 bpm. On the other hand, if we have a patient with an acute coronary syndrome or acute heart failure, the target [systolic] blood pressure to be reached is <140 mm Hg and should not go <120 mm Hg.