An Asymptomatic 40-year-old male presents with HI 230/110 mm Hg. Fundus shows grade II hypertensive retinopathy. His treatment should not be (DPG 2011)
· The initial goal in hypertensive emergencies is to reduce the pressure by no more than 25% (within minutes to 1 or 2 hours) and then toward a level of 160/100 mm Hg within 2-6 hours.
· Excessive reductions in pressure may precipitate coronary, cerebral, or renal ischemia. To avoid such declines, the use of agents that have a predictable, dose-dependent, transient and not precipitous antihypertensive effect is preferable. In that regard, the use of sublingual or oral fast-acting nifedipine preparations is best avoided.
· Patients with less severe acute hypertensive syndromes can often be treated with oral therapy.
· Abrupt blood pressure lowering is not usually necessary in asymptomatic individuals, and the use of agents such as rapid-acting nifedipine probably causes more adverse effects than benefits.