Management of severe hypertension
• malignant or severe hypertension (diastolic BP >140 mmHg), admitted to hospital for treatment.
• aim to reduce diastolic BP slowly (over 24–48 hours) to 100–110 mmHg with oral antihypertensives, e.g. atenolol or amlodipine.
• Sublingual and intravenous antihypertensives may produce a sever fall in BP, leading to cerebral infarction
• When rapid control of BP is required (e.g. aortic dissection), the agent of choice is intravenous sodium nitroprusside or labetalol.