If the initial clinical examination or investigations have identified target organ impairment in the presence of significantly elevated BP, then the diagnosis of a hypertensive emergency is established and expedient, controlled and progressive lowering of the blood pressure is indicated.
Should BP be lowered to normal levels for these patients?
The goal is not to immediately reduce BP to normal levels. Sudden large drops in blood pressure may compromise blood flow to vital organs in which autoregulatory mechanisms (which would normally preserve blood flows) are damaged.