Question

A 70-year-old woman presents to the emergency department with headache, nausea and blurred vision. Her blood pressure is 220/120 mmHg and she has bilateral papilloedema on fundoscopy. Neurological examination is otherwise normal. What is the most appropriate acute management strategy?

Accepted Answer

Lower mean arterial pressure by about 20-25% over the first few hours with intravenous antihypertensive therapy

Answer

Start oral perindopril and arrange review in 1 week

Answer

Rapidly reduce blood pressure to normal within 30 minutes using intravenous labetalol

Answer

Administer sublingual glyceryl trinitrate and discharge if headache improves

Answer

No blood pressure lowering is required unless focal neurology develops

Practice question

A 70-year-old woman presents to the emergency department with headache, nausea and blurred vision. Her blood pressure is 220/120 mmHg and she has bilateral papilloedema on fundoscopy. Neurological examination is otherwise normal. What is the most appropriate acute management strategy?