Question

A 56-year-old man with a history of hypertension presents with confusion, severe headache and vomiting. Blood pressure is 230/130 mmHg, there is papilloedema on fundoscopy and he has bilateral upgoing plantar responses. You suspect hypertensive encephalopathy. What is the most appropriate management strategy?

Accepted Answer

Lower mean arterial pressure by about 20-25% over the first few hours using IV antihypertensives

Answer

Rapidly reduce blood pressure to normal within 30 minutes using sublingual nifedipine

Answer

Avoid lowering blood pressure and treat only the headache

Answer

Start high-dose oral ACE inhibitor and review in 48 hours

Answer

Give a single dose of IV frusemide and discharge

Practice question