Visits to the emergency department (ED) addressed uncontrolled hypertension. Researchers wanted to determine how the Vanderbilt Emergency Room Bundle (VERB) intervention compared with standard care plus education in short-term blood pressure readings. In Tennessee, USA, a study team conducted a randomized trial of 206 adult patients with hypertension and increased systolic blood pressure (SBP) who presented to 2 metropolitan emergency departments. Educational materials, a brief motivational interview, a pillbox, a primary care engagement letter, pharmacy resources, and 45 days of informational and reminder text messages were all part of the VERB intervention. A hypertension pamphlet was given to the education arm. Following the enrollment of 78 people, text messages were sent out asking for confirmation of receipt. The 30-day SBP was the primary clinical outcome. The median 30-day SBP was 122 and 126 mm Hg in the VERB and education groups, respectively. The mean 30-day SBP was 3.98 mm Hg lower (95% CI, 2.44 to 10.4; P=0.22). The respective median SBPs among patients enrolled after text messages were altered 121 and 130 mm Hg, and we estimated the mean 30-day SBP in the VERB arm to be 8.57 mm Hg lower (95% CI, 0.9816.2; P=0.027). The sample’s median response rate to VERB text messages was 56% (interquartile range, [26%‒80%]). The pilot study proved the feasibility and discovered an increase in SBP in the subgroup that received interactive messages. Future trials should have evaluated the role of interactive text messaging as part of a complete emergency department intervention to improve blood pressure control.