Which medication is a vasodilator used to manage severe hypertension?

Which medication is a vasodilator used to manage severe hypertension?

• A. Fenoldopam
• B. Lisinopril
• C. Amlodipine
• D. Hydralazine

Answer: (A)

In hypertensive emergencies you want a fast-acting, controllable way to lower blood pressure. Fenoldopam fits this need because it directly dilates peripheral arteries by activating dopamine D1 receptors, with a particularly favorable effect on renal vessels. This causes a rapid drop in systemic vascular resistance and blood pressure, and because it’s given IV with a short half-life, clinicians can titrate the dose and stop quickly if the target is reached. Its renal vasodilating effect also helps preserve kidney perfusion during BP reduction. The other options don’t provide the same combination. Lisinopril is an ACE inhibitor that lowers BP by reducing angiotensin II, but it’s not a rapid IV vasodilator and isn’t suited for emergency BP control. Amlodipine is a long-acting oral calcium channel blocker, not appropriate for urgent blood pressure management. Hydralazine is a direct vasodilator and can be used in emergencies, but its response is less predictable and it often causes reflex tachycardia and fluid retention, making precise titration harder.

In hypertensive emergencies you want a fast-acting, controllable way to lower blood pressure. Fenoldopam fits this need because it directly dilates peripheral arteries by activating dopamine D1 receptors, with a particularly favorable effect on renal vessels. This causes a rapid drop in systemic vascular resistance and blood pressure, and because it’s given IV with a short half-life, clinicians can titrate the dose and stop quickly if the target is reached. Its renal vasodilating effect also helps preserve kidney perfusion during BP reduction.

The other options don’t provide the same combination. Lisinopril is an ACE inhibitor that lowers BP by reducing angiotensin II, but it’s not a rapid IV vasodilator and isn’t suited for emergency BP control. Amlodipine is a long-acting oral calcium channel blocker, not appropriate for urgent blood pressure management. Hydralazine is a direct vasodilator and can be used in emergencies, but its response is less predictable and it often causes reflex tachycardia and fluid retention, making precise titration harder.