Question

A 45-year-old man with poorly controlled hypertension presents to the emergency department with blood pressure 230/130 mm Hg, headache, and blurred vision. Fundoscopy shows papilloedema, and creatinine is acutely elevated from baseline. What is the most appropriate management?

Accepted Answer

Admit and start intravenous antihypertensive infusion to gradually reduce mean arterial pressure by no more than 25% in the first hour

Answer

Start rapid-acting oral antihypertensives and discharge

Answer

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

Answer

Delay treatment until further imaging is completed

Answer

No treatment is required because blood pressure is often elevated in hospital

Practice question

A 45-year-old man with poorly controlled hypertension presents to the emergency department with blood pressure 230/130 mm Hg, headache, and blurred vision. Fundoscopy shows papilloedema, and creatinine is acutely elevated from baseline. What is the most appropriate management?