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The primary characteristic that differentiates hypertensive urgency from hypertensive emergency is the presence of end organ damage. In hypertensive urgency, patients typically present with severely elevated blood pressure (often above 180/120 mmHg) but do not show signs or symptoms of acute end organ damage. Conversely, in hypertensive emergency, the elevated blood pressure is associated with acute damage to target organs such as the brain (e.g., hypertensive encephalopathy), heart (e.g., myocardial infarction), kidneys (e.g., acute renal failure), or other organs.

This distinction is crucial in clinical practice, as it guides the urgency and method of treatment. While the absolute blood pressure readings can often appear similar, the critical factor is whether there are clinical signs indicating damage to the organs, which influences the management approach significantly.

In terms of the other options, blood pressure readings alone are not definitive, as both conditions can present with similar levels of hypertension. The duration of hypertension, while potentially relevant, does not serve as a primary differentiator in the acute setting being assessed. Lastly, patient’s age and gender may play a role in risk stratification but do not constitute a primary characteristic for distinguishing between these two conditions.