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Published in: Pediatric Nephrology 5/2012

01-05-2012 | Educational Review

Hypertensive crisis in children

Authors: Jayanthi Chandar, Gastón Zilleruelo

Published in: Pediatric Nephrology | Issue 5/2012

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Abstract

Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.
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Metadata
Title
Hypertensive crisis in children
Authors
Jayanthi Chandar
Gastón Zilleruelo
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 5/2012
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-1964-0

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