Abstract
The severest hypertensive states pose an immediate threat to life. To be able to manage these situations, physicians need well-defined recommendations; however, as with some other emergencies, only few evidence-based strategies have been developed to date.
As randomized, placebo-controlled trials are very difficult to design and conduct, most guidelines and recommendations are based just on experience. The recommendations and opinions in the present chapter draw mainly from national, European, and American guidelines for the treatment of hypertension, and on guidelines of professional societies such as the European Stroke Organisation as well as the experience gained in the author's health-care center.