Drug ClassName of drug and Recommended dose
Fast onset of action
Calcium-channel blockersNicardipine (
95th and 99 th percentile) and mild depending upon the value of BP and end-organ dysfunction and treatment will depend upon the severity of presentation ( Figure 6) [3,5,17,22,23].
When is the surgical Intervention needed for neonatal HT?The indications for surgical treatment of NHT are few and includes renal malformations (renal vessels thrombosis/stenosis, polycystic kidney and renal tumors) and cardiovascular malformations like coarctation of aorta [26][27][28][29][30][31].
How is the prognosis of neonate with HT?The prognosis of NHT depends upon the cause of HT i.e. if cause of iatrogenic than the NHT get resolved once the precipitating factor is removed. If the neonate have features of end organ dysfunction than outcome is not favourable [28]. If the cause of NHT is renal, then HT persists in childhood. Blood pressure usually gets normalized in follow up of neonate who had NHT secondary to bronchopulmonary dysplasia [32].
ConclusionNeonatal HT has no clear definition with no proper treatment guidelines. Blood pressure should be measured in described standard manner, with the health care personal taking BP measurement should have sound knowledge of the method. The etiology of neonatal HT should be sought and before starting anti-hypertensive medication, treatable causes of neonatal HT should be sought. The commonest etiology for neonatal hypertension is reno vascular disease. The diagnostic approach includes detailed history taking (prenatal, perinatal and postnatal), clinical examination and laboratory investigations. ACE inhibitors are first line of drugs and should be used after ruling out renal artery stenosis.