Management of severe hypertension in the newborn

Arch Dis Child. 2017 Dec;102(12):1176-1179. doi: 10.1136/archdischild-2015-309740. Epub 2017 Jul 24.


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.

Keywords: antihypertensive; blood pressure; hypertension; hypertensive crisis; neonate.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure Determination / methods
  • Disease Management
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / drug therapy
  • Hypertension / etiology
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / drug therapy
  • Infant, Premature, Diseases / etiology
  • Reference Values


  • Antihypertensive Agents