Fast Five Quiz: Hypertension Management

Yasmine S. Ali, MD

Disclosures

January 24, 2019

According to the AAP, nonpharmacologic and pharmacologic treatment goals in children and adolescents diagnosed with hypertension should be a reduction in systolic BP and diastolic BP to below the 90th percentile and < 130/80 mm Hg in adolescents aged 13 years or older. The AAP also suggests that routine testing for microalbuminuria is not recommended for children and adolescents with primary hypertension. According to the JNC, pediatric hypertension is defined as high BP that persists on repeated measurements at the 95th percentile or higher for age, height, and sex.

Continuous IV infusions are the most appropriate initial therapy in acutely ill infants with severe hypertension. The advantages of IV infusions are numerous; the most important advantage is the ability to quickly increase or decrease the rate of infusion to achieve the desired BP. As in patients of any age with malignant hypertension, care must be taken to avoid too rapid a reduction in BP to avoid cerebral ischemia and hemorrhage. Premature infants, in particular, are already at increased risk because of the immaturity of their periventricular circulation. Because of the paucity of available data regarding the use of these agents in newborns, the choice of agent depends on the individual clinician's experience.

Read more on hypertension management in pediatric patients.

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