When titrating intravenous nitroglycerin for a patient with STEMI, what should the target systolic blood pressure be?

When titrating intravenous nitroglycerin for a patient experiencing ST-Elevation Myocardial Infarction (STEMI), the target systolic blood pressure is important to ensure adequate perfusion while minimizing the risk of hypotension. The choice of 90 mmHg as the target systolic blood pressure is based on the principle of maintaining sufficient systemic blood pressure to ensure that vital organs receive adequate blood flow and oxygenation.

A systolic blood pressure of 90 mmHg is typically considered a threshold that balances the risk of hypotension and the need for effective vasodilation in the management of myocardial ischemia. While lower blood pressure targets could theoretically lead to better drug efficacy in some cases, they also significantly increase the risk of reducing coronary perfusion and causing adverse events such as syncope or shock.

Maintaining the systolic blood pressure at or above 90 mmHg allows for effective treatment of chest pain and coronary arterial dilation while safeguarding against the complications that can arise from too low of a blood pressure, especially in critically ill patients with compromised hemodynamics. This strategy ultimately supports stabilizing the patient while addressing the underlying condition causing the STEMI.