IDIOPATHIC HYPERTENSION

(Id-E-O-path-ick High-per-ten-shun)

CONTENTS

What is Blood Pressure

What is Idiopathic Hypertension

What causes it

What are the symptoms

How is it treated

WHAT IS BLOOD PRESSURE (BP)

1. Blood pressure measures the pressure or force in the arteries (vessels) as the blood moves throughout the blood vessels of the body.

2. We measure a baby’s blood pressure two (2) different ways.

a. Initially many NICU babies have an umbilical artery catheter (UAC) placed (inserted) through their umbilical cord (belly button) into the aorta, the largest artery in the body

· The UAC is connected to the BP outlet of the heart monitor

· This provides us with a continuous measurement of the baby’s BP

b. The second way is to place a cuff around one of the baby’s arms or legs

· We connect the cuff to an portable electronic BP machine that pumps up (inflates) the cuff

· We place a stethoscope over the artery of the arm or leg and as the machine lets the air out of the cuff (deflate) we listen for the blood flow through the artery

· This provides us with a periodic or intermittent measurement of the baby’s BP.

3. There are two (2) numbers in each blood pressure measurement.

a. The first or top number is the systolic (sis-stall-ick) BP—this measures the force of blood pumped out of the heart when the heart beats

b. The second or bottom number is the diastolic (die-a-stall-ick) BP—this measures the pressure of the blood in the arteries when the heart relaxes to refill.

4. Blood pressure measurements are written this way: 44/21, 64/41, 95/58, 100/70, etc.

a. Changes in the BP measurement are normal and are not cause for concern

b. Blood pressure rises (increases) as your baby gets better and as he/she grows.

5. When a person’s BP (infant, child or adult) is above what is normal for their age on 3 or more consecutive measurements, we say they have High Blood Pressure or Hypertension.

WHAT IS IDIOPATHIC HYPERTENSION

1. Sometimes the cause of hypertension is known; at other times we do not know the cause of the hypertension.

2. In medicine, Idiopathic (id-e-o-path-ick) is the word we use to describe a patient’s condition when we do not know the cause.

3. Therefore Idiopathic Hypertension is an elevated or high BP that we do not know or can’t determine the cause of it.

WHAT CAUSES IT

1. There are many possible causes of hypertension; please discuss this with the Neonatologist and/or Neonatal Nurse Practitioner.

2. Use of an umbilical artery catheter (UAC).

3. Pain.

4. Certain medications (e.g., caffeine, steroids, bronchodilators).

5. Respiratory problems (e.g., bronchopulmonary dysplasia [BPD]).

6. Use of TPN (intravenous [IV] “yellowish-green” feeding).

7. Exposure to illegal drugs while in the uterus (e.g., cocaine, heroin).

8. Unknown or idiopathic.

WHAT ARE THE SYMPTOMS

1. Most babies with hypertension will not have symptoms.

a. Symptoms can range from very mild to the more serious

b. Most babies have either mild or moderate symptoms.

2. Symptoms are more likely to be related to the condition causing the hypertension and may include any of the following:

a. Cyanosis (bluish skin)

b. Pale skin (pallor)

c. Rapid breathing or difficulty breathing

d. Irritability

e. Failure to gain weight.

HOW IS IT TREATED

1. Treatment is based on the baby’s symptoms and varies from baby to baby.

Reviewed/Revised: 07/11

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