Related Experiment Video

Updated: May 30, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Hypertensive crisis in children

Jayanthi Chandar1, Gastón Zilleruelo

  • 1Department of Pediatrics, Division of Pediatric Nephrology, Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, FL, USA.

Pediatric Nephrology (Berlin, Germany)
|July 21, 2011
PubMed

Insights

Hypertensive crisis in children is rare and often linked to other diseases, with the renin-angiotensin system playing a key role. Management requires careful blood pressure reduction to avoid organ damage.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Hypertensive crisis is uncommon in pediatric populations.
  • It is frequently secondary to underlying medical conditions.
  • The renin-angiotensin system is implicated in its development.

Purpose of the Study:

  • To review the pathophysiology, diagnosis, and management of hypertensive crisis in children.
  • To highlight the importance of differentiating chronic, acute, and acute-on-chronic severe hypertension.
  • To discuss current therapeutic strategies and medications.

Main Methods:

  • Literature review of pathophysiology, diagnosis, and management.
  • Analysis of the role of the renin-angiotensin system.
  • Discussion of clinical principles in managing pediatric hypertensive emergencies.

Main Results:

  • Severe hypertension in children often requires urgent management to prevent end-organ damage.
  • Gradual blood pressure reduction is crucial; precipitous drops can impair vital organ perfusion.
  • Commonly used medications include nicardipine, labetalol, and sodium nitroprusside.

Conclusions:

  • Accurate diagnosis and classification of severe hypertension are essential for appropriate pediatric management.
  • Understanding the renin-angiotensin system's role aids in therapeutic decisions.
  • Effective management involves a stepwise approach to blood pressure control using specific antihypertensive agents.

Related Concept Videos

Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Blood Pressure01:30

Blood Pressure

Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...