Question

A 72-year-old woman with long-standing hypertension and diabetes presents with acute dyspnoea, orthopnoea and bilateral basal crackles. Blood pressure is 210/120 mm Hg, heart rate 110 beats/min, oxygen saturation 88% on room air. There is no focal neurological deficit or chest pain. What is the most appropriate immediate blood pressure management target in the emergency department?

Accepted Answer

Lower systolic blood pressure to <160 mm Hg over the first 2 hours while treating pulmonary oedema

Answer

Reduce mean arterial pressure by more than 50% within the first hour

Answer

Rapidly normalise blood pressure to 120/80 mm Hg within 1 hour

Answer

Avoid active blood pressure lowering unless systolic BP exceeds 240 mm Hg

Answer

Start oral antihypertensives and discharge once symptoms improve

Practice question