The emergency management of severe hypertension.

Severe hypertension in childhood is a life-threatening clinical problem that carries with it not only serious sequelae of inadequate treatment but equally serious complications of over enthusiastic therapy. The majority of cases have some form of underlying renal disease. Therapeutic success is achieved by slow and safe reduction of blood pressure with the immediate target of avoiding hypertensive sequelae yet allowing preservation of target organ function. Short-acting parenteral antihypertensives are recommended along with careful blood pressure monitoring to prevent complications arising through loss of autoregulatory control.