Introduction: Plannig of therapeutics and diagnostic interventions is among the prioritary objectives of a modern hospital, even more in the emergency room, where the timing of intervention runs parallel with the definition of the appropriate therapeutic strategies. Material and Methods: To define the impact of hypertension on the emergency area of an hospital, we analyzed the diagnosis of hospital discharges for the year 2008. On 79.900 admissions, the hypertension, as the single, primary or secondary diagnosis, appeared in 6.488 cases (8%). The hypertensive emergencies represented the 1,2% of all ordinary refuges (M/F: 1,3; age: 52–90 years), with the following distibution: Heart Attacks 30%, APE, 13%, Ischemich Stroke 47%, Hemorragic Stroke/SAH 9%. Discussion: Althougth the low impact of the hypertensive emergencies on the activities of the Reay Help of “A. Cardarelli” Hospital in Naples, the middle age of our population underlines more large involvement of the geriatric patients. including pluripathology and associated polypharmacotherapy. In this context and limited to our case histories, voluntary discontinuation of antihypertensive therapy and less frequency of clinical and blood pressure follow-ups, especially in over 75-year-olds, create major problems in management of the disease and in prevention of hypertensive emergencies. Conclusion: Inadequacy blood pressure control and risk of hypertensive emergencies are correlated to a scarce adherence to pharmacological therapy. The studies that have faced this aspect offer resulted varying, both for the overassessment of same methods of survey and for the underassessment of demographic indicators. The necessity to prevent these events, which are burden on society in terms of costs and, moreover, in terms of incipient disability, requires to adopt management measures able to guarantee better capillarity of diagnostic and therapeutic intervention.