- Any symptoms — headache, chest pain, breathlessness, confusion, visual change?
- Has he had his usual antihypertensives? Is he in pain or retaining urine?
- Is she pregnant or recently postnatal?
Do now
- Repeat manually, correct cuff
- Look for organ damage: neuro, fundi, ECG, U&E, urine dip, troponin if chest pain
- No organ damage: give missed meds, treat pain / retention, recheck — avoid rapid lowering
- Organ damage → hypertensive emergency (senior / HDU)
Key doses
- Asymptomatic: restart usual oral antihypertensives; no IV treatment
- Emergency: IV agents per local protocol — senior
Typical adult doses — always check the BNF and your local guideline.
Call your senior if
- Any organ damage
- Pregnant or postnatal (pre-eclampsia)
- Suspected stroke or dissection
Think of
- Pain / retention / missed meds
- Hypertensive emergency
- Pre-eclampsia
- Stroke
Go deeper
The full walkthroughs behind this call.