Hypertension

Evidence  

https://www.e-cep.org/journal/view.php?number=20125555532 

Kathleen Altemose and Janis M. Dionne 

Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related, and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course. 

Education 

What is blood pressure? 
Blood pressure is how hard the blood pushes on the walls of the blood vessels when the heart pumps. 

• The top number (systolic) shows the pressure when the heart beats. 

• The bottom number (diastolic) shows the pressure when the heart rests. 

Blood pressure measurements are written this way: 120/80 

What is high blood pressure (Hypertension)? 

High blood pressure means the numbers are higher than they should be. This can happen if: 

• The baby has a problem with the heart or kidneys. 

• The baby was born early (premature). 

• There was a blood clot in a kidney blood vessel (sometimes from a tube in the belly button). 

• The baby has certain illnesses, tumours, thyroid problems, or inherited conditions (problems that run in families). 

• Some medicines or drugs can also cause high blood pressure. 

What are the signs? 
Many babies with high blood pressure don’t show any signs. Sometimes, the signs are linked to the problem causing it. These may include: 

• Blue-looking skin 

• Not growing or gaining weight 

• Getting sick often with urine (wee) infections 

• Looking pale 

• Breathing fast 

If the blood pressure is very high, a baby may have: 

• Irritability (very unsettled) 

• Seizures (fits) 

• Trouble breathing 

• Vomiting 

As babies grow, their blood pressure naturally increases. It’s normal for blood pressure numbers to vary. 

If a baby’s blood pressure stays high, the healthcare team may give medicine to help lower it. This helps protect the baby’s heart and kidneys. The type and amount of medicine are chosen carefully for each baby. 

In the neonatal unit, babies have their blood pressure checked often. This helps doctors and nurses see if the treatment is working and to make sure the baby stays safe. 

Empowerment 

Having a baby in the neonatal unit can feel overwhelming, especially if your baby has high blood pressure. Remember you are an important part of your baby’s healthcare team. 

• Stay involved: You can be with your baby during checks and ask the doctors or nurses to explain what the blood pressure numbers mean. 

• Ask questions: If you don’t understand something, it’s okay to ask again. Your baby’s healthcare team wants you to feel confident and included. 

• Healthy routines matter: Once your baby is stable, things like a healthy diet, safe play, and regular check-ups as they grow will support their heart and blood pressure. 

• Follow the care plan: Even if your baby looks well, medicines, special feeds, or regular blood pressure checks may still be needed.  

• You are not alone: Many parents feel scared or worried. Talking to your baby’s healthcare team, support groups, or other families who have been in the neonatal unit can help. 

Useful Links 

Hypertension Australia 

https://www.hypertension.org.au 

Health Direct Australia 

https://www.healthdirect.gov.au/what-is-a-healthy-blood-pressure 

The Stroke Foundation 

https://strokefoundation.org.au/about-stroke/prevent-stroke/high-blood-pressure 

The Heart Foundation  

https://www.heartfoundation.org.au/bundles/your-heart/blood-pressure-and-your-heart

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