Acute hypertensive crises in children: emergencies and urgencies.

Hypertensive crises result from acute elevations in blood pressure. Although uncommon in children, they can be life-threatening and require immediate recognition and treatment to decrease morbidity. The diagnosis is made following complete history and physical assessment, with confirmation of blood pressure elevation using an appropriate-size blood pressure cuff. There are various options for treatment. Some of the more commonly used agents include nitroprusside, diazoxide, hydralazine, labetalol, esmolol, nicardipine, nifedipine, enalaprilat, and minoxidil. Close monitoring of blood pressure during treatment is mandatory to ensure a good outcome.