Type of severe asymptomatic hypertensionRecommendations
Hypertensive urgency*Initiate treatment and follow-up within 24 to 48 hours of presentation.
Initiate a maintenance dose of an oral medication before discharge in patients with SBP of 200 mm Hg or greater, or DBP of 120 mm Hg or greater; this is optional for patients with lower blood pressure.
Consider a short observation period, depending on the patient's risk factors.
Safely discharge the patient, emphasizing the importance of close follow-up.
If follow-up is uncertain and the patient has many risk factors, consider hospitalization for initial therapy.
Severe uncontrolled hypertensionInitiate treatment and follow-up within one to seven days of presentation.
Initiate a maintenance dose of an oral medication before discharge in patients with SBP of 200 mm Hg or greater, or DBP of 120 mm Hg or greater; this is optional for patients with lower blood pressure.
Safely discharge the patient, emphasizing the importance of close follow-up.