Question

A 68-year-old man presents to the emergency department with severe headache, visual blurring, and chest discomfort. His blood pressure is 220/130 mm Hg. Fundoscopy shows bilateral flame-shaped retinal haemorrhages and papilloedema. Creatinine is 180 µmol/L (baseline 100 µmol/L). What is the most appropriate immediate management target?

Accepted Answer

Reduce mean arterial pressure by about 25% over the first hour using IV antihypertensives

Answer

Lower systolic blood pressure to <120 mm Hg within 30 minutes

Answer

Lower diastolic blood pressure to <80 mm Hg within 6 hours

Answer

Start oral antihypertensives and discharge with close follow-up

Answer

Observe without treatment as this is likely white-coat hypertension

Practice question