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Acute severe hypertension that is accompanied by acute target-organ injury (hypertensive emergency) is associated with substantial morbidity and in-hospital mortality, thus requiring immediate treatment in an intensive care unit.

Acute severe hypertension without acute target-organ damage (hypertensive urgency) is not associated with adverse short-term outcomes and can be managed in the ambulatory setting.

Nonadherence to previously prescribed antihypertensive medications is the most common factor leading to acute severe hypertension.

Chronic hypertension shifts the cerebral blood flow autoregulation curve to the right (i.e., to higher blood-pressure levels), which confers a predisposition to cerebral hypoperfusion at relatively high (normal) blood-pressure levels. This principle guides the pace of blood-pressure reduction in acute severe hypertension …