American Board of Internal Medicine (ABIM) Certification Practice Exam

Recent guidelines suggest achieving a blood pressure of less than what value in the outpatient setting for patients with hypertensive intracerebral hemorrhage?

1. 120/70 mm Hg

2. 130/80 mm Hg

3. 140/90 mm Hg

4. 150/100 mm Hg

The correct answer is: 130/80 mm Hg

Achieving a blood pressure of less than 130/80 mm Hg in the outpatient setting for patients with hypertensive intracerebral hemorrhage aligns with recent guidelines that emphasize the importance of controlling blood pressure to reduce the risk of recurrent events and improve overall outcomes. This target is based on evidence indicating that tighter blood pressure control can significantly lower the likelihood of further bleeding episodes and contribute to better neurological recovery. The rationale behind setting this specific target is that managing hypertension effectively is crucial in patients who have suffered an intracerebral hemorrhage. Maintaining blood pressure below 130/80 mm Hg provides a balance between reducing the risk of further vascular events and not causing complications either from excessively low blood pressure. While other options might seem reasonable, they do not reflect the updated guidelines that advocate for this more stringent target. For instance, a target of 140/90 mm Hg, while historically referenced, lacks the updated support found in recent literature that specifically addresses the unique needs of patients with a history of intracerebral hemorrhage. Similarly, other higher thresholds do not provide the optimal protection against future hemorrhagic events or manage the underlying hypertension effectively.