What is the most appropriate initial management for a patient in the emergency department with asymptomatic hypertension and a recent history of non-compliance with their medication?

The most appropriate initial management in this scenario is to administer a dose of amlodipine 5 mg orally once. Amlodipine is a long-acting dihydropyridine calcium channel blocker effective in managing hypertension. For a patient presenting with asymptomatic hypertension, particularly one who has a history of non-compliance with hypertension medications, the goal is to safely lower their blood pressure without causing acute complications or unnecessary interventions.

When managing asymptomatic hypertension, particularly in the context of non-compliance, it is often beneficial to initiate oral therapy that can offer a long-term solution while simultaneously addressing the immediate issue of elevated blood pressure. By providing amlodipine, you are starting a medication that not only helps in the acute management but also encourages adherence in the long term.

In contrast to other options, such as a referral for outpatient follow-up or performing a CT scan, these do not provide an immediate therapeutic intervention for the asymptomatic hypertension. While a referral could be part of the long-term management plan, it does not help the patient in the emergency setting. Similarly, a CT scan is not warranted unless there are neurological symptoms indicating a possible acute intracranial event. Regarding intravenous nitroglycerin, it is primarily used for acute