To assess the role of dexamethasone treatment as a cause of systemic hypertension and associated complications, blood pressure was registered prospectively before, during and after a 4-week dexamethasone course in 22 neonates with chronic lung disease. In all patients systolic blood pressure rose significantly during treatment (median rise 34 mm Hg, range 4-->59 mm Hg), without complications attributable to hypertension. In all but one patient blood pressure returned to pretreatment values within 2 weeks after stopping dexamethasone treatment.
Conclusion: Dexamethasone induced hypertension is transient, even after a 4-week course, and is not associated with hypertensive complications, so treatment is not necessary. When hypertension persists after dexamethasone withdrawal other causes should be considered.