Neonatal blood pressure regulation

Abstract

Hypertension is often viewed solely as a disease of the adult. However, early indicators of hypertension are frequently observed in young children and neonates. Having an adequate appreciation of the normal range of infant blood pressure is critical for the appropriate management of the conditions associated with elevated or abnormally low blood pressure. In healthy neonates, systolic blood pressure increases rapidly during the first 6 weeks of life with the most rapid rise observed during the first 5 days. A similar pattern is observed for diastolic pressures. The observed increases in blood pressure are positively correlated with birth weight and both gestational and postnatal age. The incidence of hypertension in the neonate has been reported to range from 0.2% to 2.6% and is frequently an indicator of other renal or cardiovascular abnormalities. Systemic hypotension is reported in 24% to 45% of very low birth weight infants and is frequently caused by hypovolemia. The regulation of blood pressure is complex and the mechanisms involved remain to be fully elucidated. The results of several investigations into the molecular mechanism(s) of hypertension are considered.