Question

A 72-year-old woman presents to the emergency department with headache and shortness of breath. Her blood pressure is 220/125 mmHg, heart rate 100 beats/min, and she is confused with bilateral papilloedema on fundoscopy. Serum creatinine is 220 µmol/L (baseline 90 µmol/L). There is no chest pain. What is the MOST appropriate immediate blood pressure management strategy?

Accepted Answer

Reduce mean arterial pressure by no more than 25% over the first few hours using an intravenous antihypertensive infusion

Answer

Rapidly reduce systolic BP to <120 mmHg within 30 minutes using intravenous labetalol

Answer

Give oral amlodipine and review BP in 4 hours

Answer

Commence clonidine and arrange next-day medical review

Answer

Withhold all antihypertensives until a CT brain is completed

Practice question