A 58-year-old man with long-standing hypertension presents with blood pressure readings of 210/125 mmHg in clinic. Fundoscopy reveals bilateral flame-...

Question

A 58-year-old man with long-standing hypertension presents with blood pressure readings of 210/125 mmHg in clinic. Fundoscopy reveals bilateral flame-shaped retinal haemorrhages and papilloedema. He complains of headache and visual blurring. What is the most appropriate immediate management?

Accepted Answer

Admit urgently for intravenous blood pressure lowering in hospital

Answer

Start Amlodipine in primary care and review in 1 week

Answer

Start Ramipril and advise home blood pressure monitoring

Answer

Reassure and arrange ambulatory blood pressure monitoring

Answer

Start Thiazide diuretic and review in 3 months

uk-plab-1 MCQ (SBA): Accelerated (malignant) hypertension

A 58-year-old man with long-standing hypertension presents with blood pressure readings of 210/125 mmHg in clinic. Fundoscopy reveals bilateral flame-shaped retinal haemorrhages and papilloedema. He complains of headache and visual blurring. What is the most appropriate immediate management?