From the Guidelines
A mean arterial pressure (MAP) above 130 mmHg is considered too high in thrombolysed patients, and above 150 mmHg in non-thrombolysed patients. For optimal health, a normal MAP should range between 70-100 mmHg. If your MAP consistently exceeds these values, you should consult a healthcare provider as this indicates hypertension. The American College of Cardiology and American Heart Association guideline 1 recommends lifestyle modifications and medications to manage high blood pressure. Treatment typically begins with lifestyle modifications including reducing sodium intake, regular exercise, maintaining a healthy weight, limiting alcohol, and quitting smoking. If these measures are insufficient, medications may be prescribed, such as ACE inhibitors, ARBs, calcium channel blockers, or diuretics. The specific medication regimen will depend on your individual health profile. High MAP is concerning because it increases the workload on your heart and can damage blood vessels over time, leading to serious complications like heart disease, stroke, and kidney damage. According to the study by 1, in case of complications due to hypertension, the BP should be reduced slowly and cautiously to the target values of systolic BP 140–160 mmHg, diastolic BP 80–90 mmHg, and MAP 90–120 mmHg. Regular blood pressure monitoring is essential for those with elevated MAP to ensure treatment effectiveness.
Some key points to consider:
- The 2017 American College of Cardiology/American Heart Association hypertension guideline 1 provides recommendations for the classification of blood pressure and diagnosis of hypertension.
- The guideline recommends greater use of out-of-office blood pressure measurements to confirm the diagnosis of hypertension and titrate medication.
- The study by 1 provides recommendations for blood pressure control in patients with cerebral infarction, including the use of intraarterial blood pressure monitoring and therapeutic anticoagulation.
- The American College of Cardiology and American Heart Association guideline 1 recommends lifestyle modifications and medications to manage high blood pressure, and provides a classification system for blood pressure that includes elevated blood pressure, stage 1 hypertension, and stage 2 hypertension.
It is essential to consult a healthcare provider to determine the best course of treatment for individual cases of high MAP, as the specific medication regimen and lifestyle modifications will depend on the individual's health profile and medical history.
From the Research
Mean Arterial Pressure (MAP) Considered Too High
- The definition of a high MAP can vary depending on the context and population being studied.
- According to a study published in 2022 2, a high MAP goal was defined as a MAP of 70 mm Hg or more in critically ill medical patients.
- Another study published in 2023 3 compared a higher MAP target of 75-85 mm Hg to a lower MAP target of 65 mm Hg in adults with shock, and found no difference in mortality between the two groups.
- A study published in 2021 4 found that 24-hour MAP levels of ≥96 mm Hg were associated with an increased risk of major adverse cardiovascular events.
- In the context of sepsis, a study published in 2023 5 found that a high MAP (>65 mmHg) was associated with reduced 30-day mortality compared to a permissive low MAP (60-65 mmHg).
- In acute traumatic spinal cord injury, the goal is to elevate MAP to >85 mmHg to increase blood flow to the injured spinal cord 6.