What are the other Names for this Condition? (Also known as/Synonyms)

• Hypertension in Infants

What is High Blood Pressure in Infants? (Definition/Background Information)

• An increase in the pressure exerted by circulating blood on the walls of arteries in infants is known as High Blood Pressure in Infants. The condition affects newborns and babies under the age of one year
• An increase in blood pressure is called hypertension. Hypertension in Infants may be manifested as breathing difficulties, cyanotic (bluish) skin, problems with weight gain, and seizures
• Babies born prematurely, or with a congenital heart, lung, or kidney disease, or born to mothers who have used illegal drugs during pregnancy, are more at risk for developing high blood pressures
• Besides the above, a narrowing of the aorta or renal artery, certain tumors and inherited disorders, and the use of some medications by the mother, can cause elevated blood pressures in the baby
• The diagnosis of High Blood Pressure in Infants typically involves a complete physical examination and imaging studies of the heart, lungs, and abdomen. Depending on the underlying cause, the condition may be treated with medication, dialysis, surgery to repair damaged blood vessels, and if necessary, an organ transplant
• High Blood Pressure in Infants is not a preventable condition. However, prospective parents may benefit from medical counseling in case of a family history of congenital heart diseases. Also, avoiding the use of certain medicines, drugs, or hormones during pregnancy, is beneficial
• The outcome of High Blood Pressure in Infants is determined by the cause of hypertension, co-existing conditions and damage, if any, to the internal organs owing to increased blood pressure

Who gets High Blood Pressure in Infants? (Age and Sex Distribution)

• High Blood Pressure in Infants is observed in newborns and babies below 12 months old
• The condition can affect both boys and girls
• It is observed worldwide and all racial and ethnic groups are at risk
• The exact global prevalence of the condition is unknown. But, it is estimated to range between 0.2% to 3% in newborns

What are the Risk Factors for High Blood Pressure in Infants? (Predisposing Factors)

The most common risk factors associated with High Blood Pressure in Infants include:

• Premature birth
• Underlying diseases or abnormalities of the following organs:
  • Heart
  • Kidneys
  • Lungs
• Umbilical catheterization
• Family history of congenital heart disease, kidney disease, or high blood pressure
• Low birth weight
• Mother’s smoking, use of illegal drugs, or certain medications during pregnancy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of High Blood Pressure in Infants? (Etiology)

Some known causes of High Blood Pressure in Infants include:

• Congenital kidney diseases
  • Renal artery stenosis, in which a narrowing of the arteries that carry blood to one or both kidneys occur
  • Polycystic kidney disease, which can cause damage to small blood vessels
• Endocrine disorders such as congenital hyperthyroidism, hyperaldosteronism, and pheochromocytoma
• Congenital heart conditions such as
  • Coarctation of the aorta: It is a birth defect causing narrowing of a part of the aorta (a major artery leading out of the heart)
  • Patent ductus arteriosus: It is a congenital heart disorder in infants in which the ductus arteriosus (a blood vessel between the aorta and pulmonary artery) fails to close after birth
• Bronchopulmonary dysplasia: A chronic lung disease which occurs in preterm neonates treated with oxygen therapy
• A blood clot in the kidney blood vessel caused by inserting an umbilical catheter
• Use of certain medications during pregnancy, such as steroids, which can affect the kidneys of the fetus
• Use of illegal drugs (like cocaine) by the mother during pregnancy
• Smoking during pregnancy
• Tumors such as neuroblastoma and Wilm’s tumor

What are the Signs and Symptoms of High Blood Pressure in Infants?

The signs and symptoms of High Blood Pressure in Infants may not be apparent or specific. They may vary in severity from one child to another. The signs and symptoms may include:

• Pale skin; cyanotic skin (skin with a bluish tinge)
• Rapid breathing
• Failure to gain weight; failure to grow
• Frequent urinary tract infections
• Breathing difficulties
• Irritability, feeding difficulties
• Constant vomiting
• Heart and/or kidney failure
• Seizures

How is High Blood Pressure in Infants Diagnosed?

The diagnosis of High Blood Pressure in Infants is made by the following tools:

• A complete physical examination of the child and an assessment of symptoms
• Evaluation of family medical history, pertinent to heart and kidney diseases
• Measurement of blood pressure using an automatic device. If it is higher than 64/41 in a neonate or over 95/58 in an infant, the blood pressure is high
• Checking the pulse in the wrist and legs: A decreased pulse in the legs may be indicative of coarctation of the aorta as the cause

The following tests may be undertaken to understand the cause of Hypertension in Infants:

• Angiography: A special type of X-ray, which uses a dye to visualize the blood vessels
• Blood tests for checking the function of the heart and kidneys, as well as hormone levels
• Urine tests to check for the function of kidneys
• X-ray of the chest and abdomen
• Ultrasound of the heart and kidneys
• Echocardiogram of the heart
• Computed tomography (CT) scan and magnetic resonance imaging (MRI) test, as necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis

What are the possible Complications of High Blood Pressure in Infants?

Some potential complications of High Blood Pressure in Infants (particularly if the condition persists over a period) may include the following:

• Heart failure (left ventricular hypertrophy)
• Kidney failure
• Damages to the vital organs, such as encephalopathy, affecting the brain
• Damage to the eyes (retinopathy)
• Seizures

How is High Blood Pressure in Infants Treated?

The treatment for managing High Blood Pressure in Infants is typically aimed at addressing the underlying cause of the condition, if it is treatable. The general methods for treatment include:

• Use of anti-hypertensive medication intravenously, if the blood pressure is very high (renal vascular hypertension)
• Oral blood pressure medication, such as angiotensin-converting enzyme inhibitors, if the increase in blood pressure is moderate
• Diuretics to control blood pressure
• Dialysis to address kidney failure
• Surgery, which may include:
  • Repair the aortic coarctation, if any
  • Organ transplant, if required

How can High Blood Pressure in Infants be Prevented?

• Currently, there are no specific methods or guidelines to prevent High Blood Pressure in Infants, if it caused by a genetic condition
• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks, before planning for a child
• If a woman is on prescription medication for any condition, consultation with a healthcare professional before getting pregnant is recommended. Exposure to some medications (such as steroids) around or during pregnancy, may cause High Blood Pressure in Infants
• Use of illegal drugs and cigarettes during pregnancy has been shown to increase blood pressure in children, along with other health issues. Quitting these habits before pregnancy may help avoid major health issues in children

What is the Prognosis of High Blood Pressure in Infants? (Outcomes/Resolutions)

• The prognosis for High Blood Pressure in Infants is dependent upon the cause of the condition, early diagnosis, and prompt and aggressive treatment
• In children, in whom elevated blood pressures are caused by umbilical artery catheterization, the outcome is reported to be favorable
• If the cause is certain genetic conditions, such as polycystic kidney disease, the hypertension may persist during early childhood stages and beyond. It may need monitoring and management for a period
• If the blood pressure has been elevated consistently over a period of time, organ damage (such as kidney failure, left ventricular hypertrophy, and encephalopathy) may take place, making the prognosis guarded

Additional and Relevant Useful Information for High Blood Pressure in Infants:

Please visit our Congenital & Genetic Disorder Health Center for more physician-approved health information:

http://www.dovemed.com/diseases-conditions/congenital-genetic-disorders/