Hypertensive crises in pediatric ages

Abstract

In the present work we make a review of the different cut-off points of severe arterial hypertension that can cause a hypertensive crisis. We intend to update the criteria for the diagnosis and treatment of hypertensive crises in pediatric ages. The epidemiology, etiology, pathophysiology and clinical manifestations of hypertensive crises are described. Therapeutic management is addressed taking into account the characteristics of each patient, the most used drugs, doses and route of administration, with the recommendation to avoid the sharp drop in blood pressure figures due to the damage it can cause. There is no consensus in pediatrics on the cut-off point that defines severe hypertension can develop a hypertensive crisis. The severity of blood pressure figures alone does not define the severity of the crisis, an acute change in blood pressure is more relevant than the absolute degree of BP elevation. Systemic or target organ involvement is what makes the difference between urgency and hypertensive emergency and the speed of treatment. We conclude that hypertensive crises in pediatric ages occur more frequently in secondary arterial hypertension, however, they can occur in adolescents with essential arterial hypertension. There is no consensus in pediatrics on the cut-off point that defines severe hypertension can develop a hypertensive crisis.

Hypertensive crises; high blood pressure; emergencies, children and adolescents.