ACC/AHA BP 2017 — 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

This guideline has been superseded by a newer recommendation. Check the Knowledge Map or the current topic page for the guideline that replaces it.

Hypertensive emergency is defined by acute, severe blood pressure elevation with progressive target-organ damage (encephalopathy, ICH, ischemic stroke, acute pulmonary edema, ACS, dissection, AKI, eclampsia). For most emergencies, reduce MAP by <= 20-25% in the first hour using titratable IV infusions (nicardipine, clevidipine, labetalol), then toward 160/100 mmHg over 2-6 hours. Exceptions: Aortic dissection mandates rapid SBP < 120 mmHg within 20 min; Acute Ischemic Stroke requires permissive hypertension unless candidate for thrombolysis (target < 185/110 mmHg).