In hypertensive emergencies, how should blood pressure be reduced?

• A. Liver and kidneys.
• B. Bone marrow.
• C. Skeletal muscle.
• D. Brain and kidneys.

Answer: (D)

In hypertensive emergencies, the priority is to protect organs that are most vulnerable to high pressure, especially the brain and kidneys. Lower blood pressure gradually to reduce ongoing end-organ injury while preserving enough perfusion to these critical tissues. A typical approach is to decrease mean arterial pressure by about 20–25% in the first hour, then continue a gradual reduction toward a safer range (often around 160/100–110 mmHg) over the next several hours, using IV antihypertensives with continuous monitoring. This strategy helps prevent further brain injury, such as edema or hemorrhage, and kidney injury. The other organs listed aren’t the main targets for a rapid, controlled BP reduction in this scenario.