Neonatal hypertension: diagnosis and management

Hypertension in the term or preterm neonate may be seen in up to 2% of all infants cared for in the modern neonatal intensive cars unit. Although the definition of hypertension in this age group has not been completely standa rdized, recent studies have provided new normative data that may be used to facilitate identification of such infants. Common causes of hypertension i n neonates include thromboembolic events related to umbilical catheterizati an. congenital problems such as aortic coarctation, structural renal malfor mations and renovascular disease, as well as acquired renal disease and cer tain medications. A careful history and physical examination will usually i dentify the probable cause in most cases without the need for extensive lab oratory or radiologic testing. Therapy of neonatal hypertension should be t ailored to the severity of the blood pressure elevation, and to the underly ing cause of hypertension as appropriate. A wide range of therapeutic agent s are now available for management of neonatal hypertension in both the acu te and chronic settings. In most cases hypertension will resolve, but some infants may require prolonged treatment.