Hypertension in infancy

Hypertension in infants is rare and requires a thorough evaluation. The incidence of hypertension in infancy has risen in recent years, reflecting both better monitoring methods and increasingly successful salvage of smaller and smaller newborns. Overall mortality and morbidity rates for uncontrolled hypertension in infants are unknown. With appropriate treatment, the prognosis for resolution of hypertension is good. In most cases, hypertension is short-lived and blood pressures return to normal even when medication is discontinued. Recent experience with improved antihypertensive agents in infancy has meant that nephrectomy for renovascular hypertension is rarely required. There is still much to learn about the indications for treatment of elevated blood pressures in infancy and the potential adverse effects of therapy. Infants with a history of neonatal hypertension should be followed closely because the long-term prognosis is not known and recurrence of hypertension remains a possibility. Because hypertension can develop in high-risk newborns following discharge from the nursery, these infants deserve routine blood pressure measurements as part of their outpatient follow-up.