How should hypertensive emergencies in older adults be managed?

Managing hypertensive emergencies in older adults requires a careful and systematic approach. The correct strategy is to ensure a controlled decline in blood pressure while monitoring the patient's condition closely. Rapidly lowering blood pressure can lead to significant complications, including ischemic events such as stroke or myocardial infarction, especially in older patients who may have a decreased ability to tolerate sudden changes in blood flow.

In a hospital setting, using intravenous medications allows for precise adjustments in response to the patient’s evolving condition. Monitoring vital signs, neurological status, and renal function during this process is crucial to prevent adverse outcomes. This methodical approach ensures that blood pressure is reduced gradually to safer levels, ideally within 24 hours, without compromising end-organ perfusion.

The other options, while they may touch on aspects of hypertensive management, do not align with the best practices for handling emergencies in an older demographic, emphasizing the importance of controlled and monitored treatment in this vulnerable population.