Urgent treatment required

1. Accelerated hypertension (severe hypertension with grade III/IV retinopathy)
2. Severe hypertension (>200/120 mmHg)
3. Impending complications (such as transient ischaemic attack or heart failure)

Possible secondary hypertension

1. Endocrinopathy (Cushing's syndrome, hyperaldoster-onism, phaeochromocytoma, acromegaly)
2. Renal impairment
3. Proteinuria or haematuria
4. Resistant hypertension (more than 3 drugs)
5. . Young hypertensive (age <45 years)

Special situations

1. Multiple drug intolerance
2. Persistent non-compliance
3. Unusual blood pressure variability
4. Pregnancy
5. White coat hypertension