American Board of Internal Medicine (ABIM) Certification Practice Exam

In an inpatient setting, if a patient's systolic blood pressure exceeds 150 mm Hg with intracranial hemorrhage, it should be reduced to less than what value?

1. 130 mm Hg

2. 140 mm Hg

3. 150 mm Hg

4. 160 mm Hg

The correct answer is: 140 mm Hg

In the context of managing a patient with intracranial hemorrhage, it is essential to maintain blood pressure within a specific range to reduce the risk of further brain injury and complications. Elevated systolic blood pressure, particularly above 150 mm Hg, can exacerbate bleeding and increase intracranial pressure. The recommended target for systolic blood pressure reduction in these cases is to lower it to below 140 mm Hg. This threshold has been supported by various clinical guidelines and studies, which indicate that maintaining systolic blood pressure below this level can minimize the risk of secondary brain injury while still ensuring adequate cerebral perfusion. Thus, the guideline for patients with intracranial hemorrhage recommends that if the systolic blood pressure exceeds 150 mm Hg, it should be reduced to less than 140 mm Hg to optimize outcomes and minimize further complications.