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. 2025 May 19;8(5):e70696.
doi: 10.1002/hsr2.70696. eCollection 2025 May.

Optimizing Mean Arterial Pressure Targets for Septic Shock Patients With Chronic Hypertension: A Narrative Review

Mutaz I Othman  1 , Emad M Mustafa  1 , Ahmed E Abdelwahab  1 , Ali A Hssain  2 , Abdulqadir J Nashwan  1   3
Affiliations

Optimizing Mean Arterial Pressure Targets for Septic Shock Patients With Chronic Hypertension: A Narrative Review

Mutaz I Othman et al. Health Sci Rep. .

Abstract

Background and aims: Septic shock is a serious infection-related condition that has a big effect on public health. To improve organ perfusion and prognosis in septic shock patients with chronic high blood pressure, optimal mean arterial pressure (MAP) targets are needed. This narrative review aims to summarize existing knowledge and factors to determine the most effective MAP targets in septic shock patients with chronic hypertension.

Methods: A careful review of relevant literature was conducted to understand the factors that affect MAP targets in septic shock patients with chronic hypertension. Long-term hypertension patients require personalized MAP targets based on age, health conditions, and septic shock severity.

Results: five studies were identified in this narrative review. Guidelines suggest 65-75 mmHg for most cases, but higher targets may be beneficial for proper organ perfusion. Continuous hemodynamic monitoring allows dynamic adjustment of MAP targets.

Conclusion: It is crucial to implement personalized MAP management strategies to achieve optimal outcomes for patients with chronic hypertension who are experiencing septic shock. However, there is a lack of consensus on optimal MAP targets among patients with chronic hypertension, which may require higher MAP targets to maintain adequate tissue perfusion. An approach that considers each patient's unique characteristics and includes ongoing assessment is critical for achieving the best MAP targets and improving patient prognosis.

Keywords: acute kidney injury; chronic hypertension; critical care; mean arterial pressure; septic shock.

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Conflict of interest statement

The authors have no conflicts of interest to disclose. Abdulqadir Nashwan is an Editorial Board member of Health Science Reports and a coauthor of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication.

Figures

Figure 1
Figure 1
Decision‐making Process MAP Targets in Septic Shock Management for Patients with Chronic Hypertension.
See this image and copyright information in PMC

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