So in the first episode, I think I made you all uncomfortable with hypertensive urgency and

hypertensive emergency. And there's different levels of discomfort. This kind of discomfort can be

quite anxiety provoking since lives can be on the line. And so, you know, it's kind of like

if you show up to a parent-teacher conference with pornography on your t-shirt and smelling like beer,

you're going to be uncomfortable, but at least there's not somebody's life on the line.

So I was looking at the New England Journal of Medicine article from November 7th of 2019.

It's titled Acute Severe Hypertension. And I think it's fair to say that the New England

General Medicines is wishy-washy as me on this. So when they say when it comes to choice of treatment,

I'll just quote them, they say there are relatively few trials comparing different agents for

hypertensive emergency and hypertensive urgency.

Treatment is largely determined by an understanding of the pathophysiological features,

the presence and type of target organ injury, the availability and costs of medications,

and physician experience with given agents.

There is considerable variability in practice regarding the

choice of medications. So I think it's fair to say that what I'm telling you, one, can change,

two may not be totally accurate for the clinical scenario that you're taking care of, and you're

going to have to consider a lot of things when managing these patients.

In nothing I say from here on out as gospel, it's based on my experiences and then reading a lot

about this over the years and some recent articles about it. But I think there are some things

there is consensus on and that we can all agree on. So, for example,

if we do agree it is truly a hypertensive emergency, again, as per the first episode, that's

very difficult to determine sometimes. But if it's for sure one, then those patients should be

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