Emergent Care / Stabilization: 
Initial assessment of a patient with markedly elevated blood pressure (BP) should be to assess for any signs or symptoms of target organ injury and hypertensive emergencies based on a thorough history and physical examination. These include but are not limited to stroke, cardiac ischemia, aortic dissection, congestive heart failure and pulmonary edema, hypertensive encephalopathy, hypertensive nephropathy / end-stage renal disease, or pregnant patients in whom markedly elevated BPs may be suggestive of preeclampsia or eclampsia.

Signs and symptoms of hypertensive emergencies are not acutely present in patients with asymptomatic hypertension.

Diagnosis Overview:
Asymptomatic hypertension is asymptomatic, markedly elevated BP without signs and symptoms of acute target organ injury.

• There is no uniformly accepted definition of markedly elevated BP, generally accepted as ≥ 160/100, although some studies use ≥ 180/110.

Hypertension is a common diagnosis. An estimated 33%-50% of adults in the United States have hypertension, and the estimated prevalence of elevated BP among emergency department (ED) visits is close to 45%.