extreme untreated hypertension

My close friend, 64 yr old male has severe hypertension. appx 10 years ago he had a severe stroke(bleed). he has left side paralaysis but can walk with cane (while still determined to walk he has had a more difficult time the past year-to the point his md asked how he felt about using a wheelchair) Since the stroke his hypertension has been poorly controlled even with 3 meds-averaging 160-200/95-110 with occasionally very high spikes. During this time about once a year he will decide to discontinue meds for a peroid of a few months and his pressure will run 180/240/ to 110/135-and he claims to feel better. Then he may all of sudden decide to go back on meds. About a month ago he again went of meds and his pressure has been really high (200/240-115/135) I have seen as high 250/150 and he claims to feel great, no symptoms. I have seen only one better reading 170/105. I am very afraid for him--I also am puzzled by
the fact he has seen his eye doctor with these very high readings and he has not asked if he has hypertension-I would have thought he would have seen evidence in his retina. I suppose my question is how much immediate danger is he in  thank you

[Encephalomalcia]

He is in extreme danger of having a stroke with this high of blood pressure.  When people get this high of blood pressure, they are usually in the hospital on IV blood pressure medicine to get the pressure down.  This high blood pressure will wear his heart out.  His left ventricle could shutdown, causing him to be unable to get his air.  He could have a severe stroke.  Make sure that his doctors know of his high blood pressure.  He really should be in a hospital.  He can go to the emergency room anytime without being seen in the clinic first.