A writing committee reviewed the eligible literature related to the critical question, a systematic review of the evidence was conducted, and the Clinical Policies Committee made recommendations (Level A, B, or C) based on the strength of evidence available. This Clinical Policy underwent internal and external expert review and was available for review by ACEP membership during an open comment period. Responses received were used to refine and enhance the final policy.

Critical Question

In adult ED patients being discharged with asymptomatic elevated blood pressure, is initiation of outpatient antihypertensive medications from the ED safe and effective?

Patient Management Recommendations

Level A recommendations. None specified.

Level B recommendations. None specified.

Level C recommendations. Consider the initiation of outpatient antihypertensive medications for patients being discharged from the ED with asymptomatic elevated blood pressure.

Patients with asymptomatic elevated blood pressure should be referred for outpatient follow-up (Consensus recommendation).

More on ACEP’s Class of Evidence framework and Recommendation Levels can be found at https://www.acep.org/patient-care/clinical-policies.

Dr. Gemme is chair and associate professor of emergency medicine at the University of Massachusetts Chan Medical School – Baystate in Springfield, Mass. In addition to emergency medicine, Dr. Gemme’s passion includes writing and composing music, playing ice hockey, and spending time with his partner and two daughters.