[Neonatal hypertension--diagnostic and therapeutic approach]

Abstract

Hypertension in the neonate is a rare disease. Although the definition of hypertension in this age group has not been completely standardized, recent studies have provided new normative data that may be used to facilitate identification of such infants. The most common causes of clinically and treatable hypertension in neonates is renal artery occlusion due to thromboembolic events related to umbilical catheterization. Additionally, congenital problems such as aortic coarctation, structural renal malformations and renovascular disease, as well as acquired renal disease and certain medications must always be considered. History and physical examination will usually identify the probable cause in most cases, and the laboratory or radiologic testing will confirm the diagnosis. Treatment of neonatal hypertension should be tailored to the severity of the blood pressure elevation, and to the underlying cause of hypertension. A wide range of therapeutic agents are now available for management of neonatal hypertension in both the acute and chronic settings, but is important to correct the iatrogenic causes before using them. In most cases hypertension will resolve, but some infants may require prolonged treatment.