Hypertension in Infants

Aka: Hypertension in Infants, Hypertension in Newborns, Neonatal Hypertension

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II. Normal Blood Pressures in young infants and newborns

  1. See Pediatric Vital Signs

III. Causes

  1. See Hypertension Causes
  2. Blood Pressure higher in upper extremity
    1. Aortic Coarctation
    2. Interrupted aortic arch
  3. Blood Pressure higher in lower extremity
    1. Renal parenchymal disease
    2. Endocrine abnormality
    3. Neonatal Seizures with transient Hypertension
    4. Hypervolemia
    5. Renovascular (Umbilical Artery Catheter complication)
      1. Aortic mural thrombi
      2. Renal artery thrombosis
      3. Renal vein thrombosis

IV. Evaluation

  1. Aortic cause suspected
    1. Evaluate for Aortic Coarctation
  2. Renal or endocrine cause suspected
    1. Serum Electrolytes with Renal Function tests (Chem8)
    2. Plasma renin
    3. Renal Ultrasound with doppler flow
  3. CNS cause suspected
    1. CT or MRI Head

V. References

  1. Bada in Korones (1993) Neonatal Decision Making, p. 152
  2. Ingelfinger (1982) Pediatric Hypertension, p. 229-240
  3. Ingelfinger in Cloherty (1991) Neonatal Care, p. 492-5
  4. Fuloria (2002) Am Fam Physician 65(1):61-8 [PubMed]

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