Table 11.

BIHS position: Management of hypertension associated with acute pulmonary oedema.

Hypertensive emergency state	Acute pulmonary oedema
Speed of BP reduction and BP targets	1. Reduce BP not more than 25% reduction in MAP, while monitoring for hypoperfusion.
	2. Adequate analgesia and oxygenation are usually first steps.
	3. All patients should have plans drawn for long term hypertension management (<140/90 mmHg prior to discharge).
Medications	IV GTN or IV nitroprusside along with a loop diuretic such as IV furosemide. CCBs and IV labetalol are best avoided in the acute phase.