Jeffrey L. Segar, MD
Peer Review Status: Internally Peer Reviewed

Definition (not fully clear):

  • Term infants: > 90/65 mm Hg
  • Preterm infants: > 80/45 mm Hg (Liberman)

Management should be directed towards correcting the underlying etiology. It is uncertain whether moderate hypertension associated with bronchopulmonary dysplasia requires therapy, since it is mostly transient. Renovascular hypertension can be managed pharmacologically.

Pharmacologic Therapy for Neonatal Systemic Hypertension
Agent Dosage Toxicity
Hydralazine 0.1-0.5 mg/kg/dose q 4-6 h IV hypotension
Propranolol 0.25 - 1.0 mg/kg/day q 6-12 h PO hypoglycemia, hypotension
Captopril 0.05 -0.1 mg/kg/dose q 6-8 h PO neutropenia, proteinuria, renal failure
Methyldopa 10 mg/kg/day q 6-12 h, followed by increments of 5-10 mg/kg/day every 2-4 days up to 65 mg/kg/day hepatitis, leukopenia