Published online Jun 16, 2015. doi: 10.12998/wjcc.v3.i6.510
Peer-review started: June 25, 2014
First decision: August 14, 2014
Revised: February 15, 2015
Accepted: March 16, 2015
Article in press: March 18 2015
Published online: June 16, 2015
Hypertensive emergencies and hypertensive urgencies in children are uncommonly encountered in the pediatric emergency department and intensive care units, but the diseases are potentially a life-threatening medical emergency. In comparison with adults, hypertension in children is mostly asymptomatic and most have no history of hypertension. Additionally, measuring accurate blood pressure values in younger children is not easy. This article reviews current concepts in pediatric patients with severe hypertension.
Core tip: Hypertensive crisis in children is a disease easily mismanaged in the emergency department. The physician should carefully search for evidence of end organ injury to distinguish between hypertensive emergency and hypertensive urgency. Only patients with hypertensive emergency require immediate reduction in markedly elevated blood pressure to prevent and arrest progressive end organ damage. In all other patients, the elevated blood pressure can be lowered slowly using oral agents, i.e., esmolol, nicardipine, labetalol and fenoldopam. All young children should receive complete examinations to look for the underlying cause of secondary hypertension.