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Management of hypertensive emergencies and urgencies in children

Joseph T Flynn, MD, MS
Section Editors
George A Woodward, MD
F Bruder Stapleton, MD
Deputy Editor
James F Wiley, II, MD, MPH


Acute severe hypertension resulting in hypertensive emergencies and urgencies occurs infrequently in children. Proper management of this potentially life-threatening condition and prevention of its complications depend on prompt recognition and treatment.

The clinician should understand that there is a spectrum of severity of acute hypertension. Any classification scheme that divides the clinical presentation of acute severe hypertension into "urgent" or "emergent" is by its nature arbitrary [1,2]. Clinical findings, especially symptoms manifested by the patient, must be used to gauge the severity of acute hypertension and guide management.

This topic discusses the rapid assessment and treatment of hypertensive emergencies and urgencies in children. The diagnostic evaluation to acute severe hypertension is discussed separately. (See "Approach to hypertensive emergencies and urgencies in children".)


Acute severe hypertension has traditionally been divided into hypertensive emergencies and hypertensive urgencies. The clinician should understand that there is a spectrum of severity of acute hypertension. Any classification scheme that divides the clinical presentation of acute severe hypertension into separate categories is by its nature arbitrary [1,2]. Clinical judgment must be used to gauge the severity of acute hypertension and guide management.

Hypertension — Hypertension in children is defined as either systolic and/or diastolic blood pressure (BP) ≥95th percentile measured upon three or more occasions. As in adults, hypertension in children is further divided into the two following stages:


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Literature review current through: Sep 2016. | This topic last updated: Jun 2, 2015.
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