Critical Issues in the Outpatient Management of Adult Patients Presenting to the Emergency Department With Asymptomatic Elevated Blood Pressure
Official 2025 Guideline from the American College of Emergency Physicians.
summary by Eric Steinberg, DO, MEHP
Recommendations
Treatment
Consider the initiation of outpatient antihypertensive medications for patients being discharged from the ED with asymptomatic elevated blood pressure.
Level C
Patients with asymptomatic elevated blood pressure should be referred for outpatient follow-up [Consensus recommendation].
Level C
What do the icons mean?
Level A
Generally accepted principles for patient management that reflect a high degree of clinical certainty (ie, based on strength of evidence Class I or overwhelming evidence from strength of evidence Class II studies that directly address all of the issues).Level B
Recommendations for patient management that may identify a particular strategy or range of management strategies that reflect moderate clinical certainty (ie, based on strength of evidence Class II studies that directly address the issue, decision analysis that directly addresses the issue, or strong consensus of strength of evidence Class III studies).Level C
Other strategies for patient management that are based on preliminary, inconclusive, or conflicting evidence, or in the absence of any published literature, based on panel consensus.
