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Acute hypertensive crises in children: emergencies and urgencies

B Fivush1, A Neu, S Furth

  • 1Johns Hopkins Hospital, Baltimore, MD 21267-2535, USA.

Insights

Hypertensive crises in children are rare but dangerous, requiring prompt diagnosis and treatment. Immediate recognition and management of acute high blood pressure are crucial to prevent severe complications.

Area of Science:

  • Pediatric Nephrology and Critical Care

Background:

  • Hypertensive crises, characterized by acute blood pressure elevations, are uncommon but life-threatening in pediatric populations.
  • Prompt recognition and intervention are essential to mitigate severe morbidity associated with these events.

Purpose of the Study:

  • To outline the diagnostic criteria and therapeutic strategies for managing hypertensive crises in children.
  • To emphasize the importance of accurate blood pressure measurement and continuous monitoring during treatment.

Main Methods:

  • Diagnosis relies on comprehensive history and physical examination.
  • Confirmation involves accurate blood pressure measurement with an appropriately sized cuff.
  • Treatment involves various pharmacological agents, with close blood pressure monitoring.

Main Results:

  • Several antihypertensive agents are available for managing pediatric hypertensive crises, including nitroprusside, diazoxide, hydralazine, labetalol, esmolol, nicardipine, nifedipine, enalaprilat, and minoxidil.
  • Effective management hinges on careful selection of agents and vigilant monitoring.

Conclusions:

  • Hypertensive crises in children necessitate immediate medical attention.
  • A combination of accurate diagnosis, appropriate treatment selection, and close monitoring is mandatory for favorable outcomes.

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