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Hypertensive crisis in children: an experience in a single tertiary care center in Korea

Geum Hwa Lee1, I Re Lee1, Se Jin Park2

  • 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.

Clinical Hypertension
|April 20, 2016
PubMed

Insights

Hypertensive crisis in children is often caused by kidney disease or cancer. Nicardipine and labetalol are effective intravenous drugs for managing this condition, showing similar blood pressure reduction and clinical outcomes.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Cardiology
  • Pediatric Oncology

Background:

  • Hypertensive crisis is a critical medical condition with potential for severe end-organ damage.
  • Etiology, treatment, and outcomes of hypertensive crisis in Korean children remain under-researched.
  • This study investigates the causes and drug efficacy for hypertensive crisis in pediatric patients in Korea.

Purpose of the Study:

  • To identify the primary etiologies of hypertensive crisis in Korean children.
  • To evaluate the effectiveness of various intravenous antihypertensive drugs.
  • To compare outcomes between hypertensive emergency and urgency in pediatric patients.

Main Methods:

  • Retrospective analysis of 51 children diagnosed with hypertensive crisis (2010-2014).
  • Patients categorized into hypertensive emergency (n=31) and hypertensive urgency (n=20) groups.
  • Comparison of baseline etiologies, risk factors, and blood pressure response to intravenous antihypertensives.

Main Results:

  • Kidney injury and cancer were identified as common underlying causes.
  • Cardiovascular, central nervous system, and retinal complications were more prevalent in hypertensive emergency.
  • Hydralazine was initially used but often ineffective; nicardipine, labetalol, or nitroprusside were subsequently administered in 45.1% of cases.
  • Nicardipine and labetalol demonstrated comparable efficacy in reducing blood pressure and improving clinical outcomes.

Conclusions:

  • Children with underlying renal diseases and cancer require vigilant blood pressure monitoring and examination.
  • Nicardipine and labetalol are effective options for intravenous management of hypertensive crisis in pediatric populations.
  • Further research into pediatric hypertensive crisis management is warranted.
Abstract

Keywords:
Antihypertensive drugsChildrenHypertensive crisis

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