Adding delivery of primary care and primary prevention to the growing list of mandated interventions delivered in the ED setting will require engaging and enabling already largely receptive ED professionals.900 ED visits serve as opportunities to screen and potentially treat patients with asymptomatic hypertension. The prevalence of asymptomatic hypertension in patients presenting to the ED may be as high as 1 in 20.901 Although patients are asymptom- atic, many have target-organ injury; an ED cohort of blacks with elevated BP in the ED found that 90% had subclinical hyper- tensive heart disease.902 In ED patients with newly identified hypertension or chronically untreated hypertension, performing screening tests in the ED for target-organ damage and tests for identifiable causes of hypertension in selected patents is appro- priate. Most asymptomatic patients will not require acute BP reduction or long-term antihypertensive medication initiation in the ED. For most newly diagnosed hypertensive patients, the ED encounter can serve as a means of arranging appropriate referral Meschia et al Guidelines for the Primary Prevention of Stroke 3799 to outpatient primary care, coupled with counseling on lifestyle modifications, although this is inconsistently performed.221,903 ED personnel can identify patients with a history of hyperten- sion but nonadherence to their medication regimen who need to resume their previous medications. ED screening for hyper- tension is feasible and cost-effective. Once hypertensive patients are identified, ED personnel can educate on and encourage healthy lifestyles to address their hypertension and the impor- tance of outpatient follow-up, in accordance with the current Joint National Committee 8 outpatient guidelines.219,896,904 The incidence of diabetes mellitus has more than doubled over the last 2 decades, and millions with the condition remain undiagnosed. 