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.

These guideline summaries are shared for educational purposes only and are not intended to direct patient care. For detail on the specific recommendations and information about the evidence considered by the guideline developer, we encourage you to go to the original guideline statement cited below.

Strength

Recommendations

Treatment

Level C

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].

Literature

Original/Primary Reference

Gemme S, et al. Clinical Policy: A Critical Issue in the Outpatient Management of Adult Patients Presenting to the Emergency Department with Asymptomatic Elevated Blood Pressure; 2025.

Summary By

Eric Steinberg, DO, MEHP

What do the ratings 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.