Mean arterial pressure (MAP) should be reduced by approximately 10 to 20% within the first hour and by another 5% to 15% over the next 24 hours. This often results in a target BP of less than 180/120 mm Hg for the first hour and less than 160/110 mm Hg for the next 24 hours, but rarely less than 130/80 mm Hg during that time frame.
It is generally not recommended to decrease the BP too quickly or too much as ischemic damage can occur in vascular territories that have become habituated with the elevated level of BP.
For most hypertensive emergencies, the MAP should be reduced gradually by approximately 10 to 20% within the first hour and by a further 5% to 15% over the next 24 hours, with a final goal of approximately 25% reduction compared with baseline.