In a case of hypertensive emergency for a 14 year-old, what is the recommended reduction of mean arterial blood pressure within the first hour?

In cases of hypertensive emergency, especially in pediatric patients, the safe and effective management of blood pressure is crucial to prevent further complications. The recommended approach includes a controlled reduction of mean arterial blood pressure (MAP) to minimize the risk of ischemic events or other adverse effects due to rapid changes in hemodynamics.

The recommended reduction for a pediatric patient, such as a 14-year-old, is approximately 25% within the first hour. This target helps to adequately lower the blood pressure while allowing the body to adjust to the changes gradually. A reduction of this magnitude is sufficient to alleviate acute end-organ damage without precipitating issues such as cerebral or renal ischemia, which could occur with more aggressive therapy.

Other options suggest either a significantly lower (5%) or higher reduction (50%) or aim to normalize blood pressure immediately. Such approaches could either be ineffective or dangerously aggressive, risking morbidity associated with too rapid a drop in blood pressure. Consequently, targeting a 25% reduction strikes an optimal balance between managing the emergency and protecting the patient's overall health.