Decrease BP by 25% of the original value every 24 hours till target BP reached.Aim to gradually reduce BP to the patient's estimated 95 th centile.Intravenous therapy discuss with renal team and retrieval/ICU team.Commence 0.25–0.5 mg/kg/day (max 20 mg) and titrate up as required to a maximum of 3 mg/kg/day (max 120 mg).Hypertensive urgency If medically stable, consider short acting oral agents while investigating cause Discuss with renal team and retrieval/ICU team.>95 th centile + 30 mmHg associated with encephalopathy,Įg headache vomiting, vision changes and neurological symptoms (facial nerve palsy, lethargy, seizures, coma) +/- target-end organ damageĮmergency management of severe hypertension Recently, the American Heart Association (AHA) updated their guidance to indicate that people age 65 and older should ideally have a blood pressure reading. Without symptoms/signs of target end organ damage (See Examination) Secondary hypertension is more common in younger children (95 th centile + 30 mmHg without symptoms/signs of target end organ damage (See Examination).Primary/essential hypertension accounts for the majority of hypertension in children >6 years old and is generally associated with obesity or a family history of hypertension.Hypertension in childhood is a key predictor of risk for hypertension, cardiovascular disease and end organ damage in adulthood.This guideline will focus on the paediatric population aged 1–17 years (not infants). ![]() Where possible, abnormal machine BP measurement should be confirmed, preferably with a manual BP, ensuring appropriately sized cuff is used for accurate measurement.The National Heart, Lung, and Blood Institute has prepared a series of age- and gender-specific blood pressure measurement tables for children ages 3 through 17 years, based on percentiles. Blood pressure should be measured annually in healthy children A teenager may have an acceptable blood pressure of 110/70 mm Hg, but that value would be of concern in a toddler.All hypertension in children requires monitoring and follow-up.Hypertension associated with encephalopathy is a medical emergency Severe hypertension requires urgent consultation and management.BP by age and height centile tables: boys girls Key points
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