AHA/ACC BP 2025 — 2025 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

Hypertensive emergency is defined by severe BP elevation with new or worsening acute target-organ damage and requires monitored, syndrome-specific treatment. Without a compelling organ-specific condition, avoid excessive first-hour reduction and then lower more gradually. For acute pulmonary edema the guideline lists clevidipine, nitroglycerin or nitroprusside and lists beta blockers as contraindicated; severe hypertension without acute target-organ damage should not be reflexively treated with rapid IV BP normalization.