There are numerous influences on normal blood pressure in neonates, including gestational age, birthweight, and maternal factors such as preeclampsia. This makes it difficult to define normal and abnormal blood pressure (BP). As in older children, identification of hypertension (HTN) in the neonate is dependent on correct BP measurement technique. While the differential diagnosis of systemic HTN in the neonate is broad, common causes include catheter-related thromboembolic phenomena, chronic lung disease, kidney disease, and iatrogenic causes. A focused diagnostic evaluation should lead to correct identification of the underlying cause in most neonates. Therapy for HTN in the neonate is largely empiric because of a lack of data on outcomes of elevated BP in neonates and exclusion of neonates from antihypertensive drug trials.
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