[Noah930]

I vote ER.

The symptoms earlier in the day may have been a TIA/RIND. Kind of a mini-stroke. (Or maybe she just swoons in your presence, who knows.) But for her BP to be elevated without reason can be concerning. It's not just the first (systolic) number--it's actually the second (diastolic) number that can be more concerning. That DBP of 100 that you recorded is slightly eyebrow-raising. Again, that puts her at risk for not just a heart attack, but a stroke as well.

I'd hate to think your friend would have waited overnight to see her PCP the next day...and then stroked out sometime in the middle of the night. If she's having issues with vision/speech/balance/etc and has a hypertension, it might be worthwhile for her to be observed overnight or to get a CT scan. Of course, she can call her PCP's office and see if she can talk to him (or the covering partner if he/she is familiar with your friend) to feel out these issues prior to visiting the ER.