Examples of target organ damage include hypertensive encephalopathy, ICH, acute ischemic stroke, acute MI, acute LV failure with pulmonary edema, unstable angina pectoris, dissecting aortic aneurysm, acute renal failure, and eclampsia. In general, use of oral therapy is discouraged for hypertensive emergencies. Hypertensive emergencies in patients with acute ICH and acute ischemic stroke are discussed in Section 9.4. In contrast, hypertensive urgencies are situations associ- ated with severe BP elevation in otherwise stable patients without acute or impending change in target organ damage or dysfunction. Many of these patients have withdrawn from or are noncompliant with antihypertensive therapy and do not have clinical or laboratory evidence of acute target organ damage. These patients should not be considered as having a hypertensive emergency and instead are treated by reinstitu- tion or intensification of antihypertensive drug therapy and treatment of anxiety as applicable. There is no indication for referral to the emergency department, immediate reduction in BP in the emergency department, or hospitalization for such patients. Figure 11 is an algorithm on diagnosis and management of a hypertensive crisis. Tables 19 and 20 summarize intra- venous antihypertensive drugs for treatment of hypertensive emergencies. Recommendation-Specific Supportive Text 1. There is no RCT evidence that antihypertensive drugs reduce morbidity or mortality in patients with hyper- However, from clinical expe- rience, it is highly likely that antihypertensive therapy is an overall benefit in a hypertensive emergency.S11.2-9 There is also no high-quality RCT evidence to inform clinicians as to which first-line antihypertensive drug class provides more benefit than harm in hypertensive This lack of evidence is related to the small size of trials, the lack of long-term follow-up, and failure to report outcomes. 