ACEP Clinical Policy — Elevated Blood Pressure in the ED (2025)

The ACEP 2025 Clinical Policy on evaluation and management of patients presenting to the emergency department with elevated blood pressure (asymptomatic hypertension, hypertensive urgency, and hypertensive emergency/crisis) provides evidence-based guidance on: evaluation for end-organ damage, treatment thresholds, medication selection, and safe disposition. This policy distinguishes hypertensive urgency (severely elevated BP without end-organ damage) from hypertensive emergency (severely elevated BP WITH acute end-organ damage — brain, heart, kidney, aorta, eye), guiding appropriate ED treatment intensity and disposition.