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Management of severe hypertension in the newborn
  1. Janis M Dionne1,
  2. Joseph T Flynn2
  1. 1 Department of Pediatrics, Division of Nephrology, University of British Columbia, BC Children’s Hospital, Vancouver, Canada
  2. 2 Department of Pediatrics, Division of Nephrology, University of Washington, Seattle Children’s Hospital, Washington, USA
  1. Correspondence to Dr Joseph T Flynn, Division of Nephrology, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S A-7931, Seattle WA48105, USA; Joseph.flynn{at}


Blood pressure is considered a vital sign, as values too low or too high can be related with serious morbidity and mortality. In neonates, normal blood pressure values undergo rapid changes, especially in premature infants, making the recognition of abnormal blood pressures more challenging. Severe hypertension can occur in neonates and infants and is a medical emergency, often manifesting with congestive heart failure or other life-threatening complications. The cause or risk factors for the hypertension can usually be identified and may guide management. Most classes of antihypertensive medications have been used in the neonatal population. For severe hypertension, intravenous short-acting medications are preferred for a controlled reduction of blood pressure. In this article, we focus on identification, aetiology and management of severe hypertension in the newborn.

  • neonate
  • blood pressure
  • hypertension
  • hypertensive crisis
  • antihypertensive

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.