Asymptomatic Hypertension

Regardless of whether you call it hypertensive urgency, non-emergent or asymptomatic hypertension, severe, uncomplicated BP or markedly elevated BP, all of the guidelines have the same general recommendations: do NOT acutely lower these patients’ blood pressure - Kelly Ryan

Asymptomatic Hypertension

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Severely Elevated Blood Pressure in the ED

In the ACEP clinical policy, the term “asymptomatic severely elevated blood pressure” replaces the term “hypertensive urgency.” Although ACEP’s definition of asymptomatic markedly elevated blood pressure suggests that a patient must be “asymptomatic,” this is not the case. ACEP’s clinical policy, along with other guidelines, state only that the patient should have no symptoms of end organ dysfunction, not that the patient must be entirely asymptomatic.

If the history and physical are not concerning for end organ dysfunction, acute testing and treatment in the ED is not routinely necessary. Should the patient lack outpatient follow up, one may elect to start an oral antihypertensive…

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Last Updated : Thursday, April 21, 2022