Neonatal hypertension: concerns within and beyond the neonatal intensive care unit

• Published in: Clinical and experimental pediatrics Vol. 65; no. 8; pp. 367 - 376
• Main Authors: Altemose, Kathleen, Dionne, Janis
• Format: Journal Article
• Language: English
• Published: Korea (South) Clinical and Experimental Pediatics / Korean Pediatric Society 01.08.2022; Korean Pediatric Society; The Korean Pediatric Society; 대한소아청소년과학회
• Subjects: antihypertensive agents; Birth weight; Blood clots; Blood pressure; blood pressure determination; cardiovascular risk factor; Catheters; Congenital diseases; Gestational age; Hypertension; Intensive care; Kidney diseases; Lung diseases; Measurement techniques; Population; Premature babies; premature infants; Review; Risk factors; Thrombosis; Veins & arteries; 소아과학; Hypertension; Premature; Cardiovascular risk factor; Blood pressure determination; Antihypertensive agents
• ISSN: 2713-4148; 2713-4148
• DOI: 10.3345/cep.2022.00486

Neonatal hypertension occurs in 1-2% of neonates in the neonatal intensive care unit (NICU) although may be underdiagnosed. Blood pressure values in premature neonates change rapidly in the first days and weeks of life which may make it more difficult to recognize abnormal blood pressure values. In addition, the proper blood pressure measurement technique must be used to ensure the accuracy of the measured values as most blood pressure devices are not manufactured specifically for this population. In premature neonates, the cause of the hypertension is most commonly related to prematurity associated complications or management while in term neonates is more likely to be due to an underlying condition. Both oral and intravenous antihypertensive medications can be used in neonates to treat high blood pressure although none are approved for use in this population by regulatory agencies. The natural history of most neonatal hypertension is that it resolves over the first year or two of life. Of concern are the various neonatal risk factors for later cardiovascular and kidney disease that are present in most NICU graduates. Prematurity increases the risk of adulthood hypertension while intrauterine growth restriction may even lead to hypertension during childhood. From neonates through to adulthood NICU graduates, this review will cover each of these topics in more detail and highlight the aspects of blood pressure management that are established while also highlighting where knowledge gaps exist.