Neonatal systemic hypertension across the PHIS database: An update

Int J Cardiol. 2023 Apr 1:376:49-53. doi: 10.1016/j.ijcard.2023.01.060. Epub 2023 Jan 20.

Abstract

Background: The definition of systemic hypertension in the neonatal population remains elusive given the variability of normative blood pressure measurements. Inadequate literature exists about incidence, therapy and long-term management of systemic hypertension in neonates. We aimed to describe the current incidence of neonatal systemic hypertension, differences in demographic and risk factors data.

Methods: Retrospective cohort of neonates (≤28 days) admitted to a neonatal intensive care unit participating in Pediatric Health Information System (PHIS) between Jan 2010 and December 2020 with an ICD 9/10 code for hypertension. Patients were excluded if they had congenital heart disease lesions that might contribute to systemic hypertension or had incomplete data.

Results: There were a total of 2494 hypertensive patients among the 432,367 NICU patients meeting the study inclusion criteria, with an incidence of 0.6%. Patients with hypertension were significantly more likely to die before discharge compared to patients without HTN (8.4% versus 3.8%, respectively, p < 0.001). Of the 2494, 52.8% received at least one antihypertensive agent, with hydralazine being the most prescribed agent (29.7%).

Conclusion: Diagnosis of Systemic hypertension continues to increase in the neonatal population, despite absence of well-defined criteria necessitating targeted medical management. A consensus guideline which addresses this very important condition is beneficial.

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Child
  • Health Information Systems*
  • Hospitalization
  • Humans
  • Hypertension* / epidemiology
  • Infant, Newborn
  • Retrospective Studies

Substances

  • Antihypertensive Agents