A 58-year-old man presents to the emergency department with a severe headache, confusion, and blurry vision. His blood pressure is 220/120 mmHg, and funduscopic exam reveals papilledema. Which of the following is the most appropriate initial pharmacological goal for blood pressure reduction in the first hour?

✓ Correct Answer: Option B

For hypertensive emergencies with end-organ damage (like encephalopathy and papilledema), the goal is to gradually reduce the mean arterial pressure by no more than 10-20% in the first hour to prevent cerebral hypoperfusion and ischemic events. Rapid, aggressive reduction can be harmful.