Clinical recommendation	Evidence rating	References
Severe asymptomatic hypertension should be distinguished from hypertensive emergency, then classified as hypertensive urgency or severe uncontrolled hypertension.	C	⁸, ^12–14
In patients with severe asymptomatic hypertension, those with more cardiovascular risk factors should be evaluated and treated more aggressively than those with fewer risk factors.	C	⁶, ¹⁶
Initiating treatment for asymptomatic hypertension in patients previously diagnosed with hypertension is optional with appropriate follow-up. However, in patients with a systolic blood pressure of 200 mm Hg or greater, or diastolic blood pressure of 120 mm Hg or greater, oral medication should be initiated before discharge.	C	⁶, ⁸, ¹², ¹⁴, ¹⁷, ²³
Blood pressure should not be expected to decrease to desired levels during the initial visit for severe asymptomatic hypertension. Blood pressure should instead be reduced gradually with repeated follow-up visits.	C	⁶, ⁸, ¹², ¹⁴, ¹⁷, ²³