Hypertensive crisis definition and actions.

• A. SBP 120-129 and DBP <80; no emergency action
• B. SBP >140 and/or DBP >90 with no organ damage; routine follow-up
• C. SBP >180 and/or DBP >120 with evidence of organ damage; seek urgent evaluation and contact emergency services
• D. SBP 200-210 with low heart rate; call primary care in 24 hours

Answer: (C)

Hypertensive crisis has two forms: an emergency and an urgency. The emergency form occurs when blood pressure is extremely high and there is evidence of acute target organ damage (such as the brain, heart, kidneys, or eyes). In this situation, immediate evaluation is needed—activate emergency services if the patient is unstable—and treatment starts in the hospital with IV antihypertensives to lower the pressure carefully and promptly, aiming for a controlled reduction rather than a rapid drop.

This question describes very high blood pressure (SBP above 180 or DBP above 120) accompanied by organ damage, and it asks for urgent evaluation and contact with emergency services. That exactly matches hypertensive emergency, where rapid but controlled BP reduction in a monitored setting is essential. Choices that omit organ damage or use different thresholds reflect hypertensive urgency or non-emergency management, which do not apply here.