Hypertension was initially recognized clinically in neonates in the 1970s, but recent technological advances in the NICU have led to heightened awareness and increased diagnostic frequency. Neonatal hypertension is defined as systolic blood pressure (BP) of at least the 95th percentile for gestational age, birthweight, and sex on 3 separate occasions. The incidence of neonatal hypertension in the NICU ranges from 0.2% to 3% and most commonly affects term and preterm infants in the intensive care setting.

Abnormally elevated BP, especially severe (defined by systolic BP >99th percentile) in critically ill or premature infants can result in vascular injury, left ventricular hypertrophy, encephalopathy, and hypertensive retinopathy. In addition to complications from end organ damage, certain forms of neonatal hypertension are linked to hypertension beyond infancy, making it imperative to swiftly diagnose and aggressively manage severe or persistent hypertension.

As with older children and adults, there are multiple causes of neonatal...

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