Yeah this very much depends on the actual specific number. I work inpatient so I don't blink at 155 systolic because we're gonna take it again in 12h and honestly these days the hospitalist says current evidence supports not even treating emergently until 170. The ED actually keeps insisting that 180 isn't their problem for patients they want admitted to psych. A small dentists office might not be up to date on current best practice for treating hypertension.

When I interviewed for a CSU they were even like "how would you approach an intake where your new pt has a BP of 180?" and I, coming from the university hospital where I had residents subject to my whims I struggled to come up with an answer that wasn't "page the oncall I guess?" But I did manage "...tell them to take some deep breaths and take it again...?" which was apparently the right answer???

150s to me is a GP/PCP's problem 3 months from now and ultimately they'll probably just tell the person to start with eating less salt. It also sounds like it was asymptomatic and there's also the possibility that the doctor just figured she wouldn't take anything anyway based on this person's description.