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. However, 2 trials have dem- onstrated that nicardipine may be better than labetalol in achieving the short-term BP target.S11.2-1,S11.2-10 S11.2-12 Several antihypertensive agents in various pharmacologi- cal classes are available for the treatment of hypertensive Figure 11. Diagnosis and management of a hypertensive crisis. Colors correspond to Class of Recommendation in Table 1. *Use drug(s) specified in Table 19. If other comorbidities are present, select a drug specified in Table 20. BP indicates blood pressure; DBP, diastolic blood pressure; ICU, intensive care unit; and SBP, systolic blood pressure. Whelton et al 2017 High Blood Pressure Clinical Practice Guideline e67 emergencies (Table 19). Because autoregulation of tis- sue perfusion is disturbed in hypertensive emergencies, continuous infusion of short-acting titratable antihyper- tensive agents is often preferable to prevent further target The selection of an antihyper- tensive agent should be based on the drug s pharmacol- ogy, pathophysiological factors underlying the patient s hypertension (as well as they can be rapidly determined), degree of progression of target organ damage, the de- sirable rate of BP decline, and the presence of comor- bidities (Table 20). The therapeutic goal is to minimize target organ damage safely by rapid recognition of the problem and early initiation of appropriate antihyperten- sive treatment. 2. 