Hello, since there is no heart disease she can probably wait till tomorrow without any problem. The fact that her heart echo was normal means that this hypertension was not long standing. In cases like hers it s important to determine whether the measurements were accurate or not by evaluating the patient s device and technique in the office. Many patients overestimate their blood pressure by measuring it when they experience a headache (the blood pressure rises during any pain) or when they feel tense (the same applies here). If the high measurements are confirmed then investigation for secondary hypertension is warranted because of the sudden appearance of the hypertension, taking into account the fact that this is not a borderline hypertension (200/100 is too much). Low salt consumption, physical activity and a healthy body weight and diet are essential measures against hypertension. Depending on her risk factors for heart disease and blood pressure measurements her doctor might decide to start drug treatment as well. I hope I ve helped! You can contact me again, if you d like more detailed information. Kind Regards!