From the Research
In patients with decompensated liver cirrhosis, the target mean arterial pressure (MAP) should be maintained at or above 65 mmHg, as evidenced by a study published in 2020 1. This typically corresponds to a systolic blood pressure of approximately 90-100 mmHg. Blood pressure management in these patients requires careful balance, as both hypotension and excessive hypertension can be detrimental. Hypotension can worsen hepatorenal syndrome and compromise organ perfusion, while excessive blood pressure can increase portal pressure and risk of variceal bleeding. Some key points to consider in managing blood pressure in decompensated liver cirrhosis include:
- The importance of maintaining a mean arterial pressure (MAP) of at least 65 mmHg, as supported by the study published in 2020 1.
- The potential use of midodrine, as seen in a study from 2025 2, which increases systemic vascular resistance without significantly affecting cardiac output.
- The cautious use of beta-blockers, which are commonly used for portal hypertension but may need dose reduction or temporary discontinuation if MAP falls below 65 mmHg or systolic pressure below 90 mmHg, as discussed in a study from 2019 3.
- Regular monitoring of blood pressure, renal function, and electrolytes is essential when managing these patients, as highlighted in various studies, including those from 2025 2 and 2020 1. The study from 2025 2 demonstrates the efficacy of midodrine and weekly albumin therapy in patients with cirrhosis and diuretic intractable or recurrent ascites, further emphasizing the importance of careful blood pressure management in these patients. Overall, maintaining an optimal blood pressure is crucial in managing patients with decompensated liver cirrhosis, and healthcare providers should be aware of the potential risks and benefits of different therapeutic approaches.