Management of hypertensive crisis in children.

The availability and rapidity of onset of pharmacologic agents for the treatment of hypertensive crisis allow the pediatrician to treat nearly every case effectively. Diazoxide seems to be the agent of choice as a first drug for the patient with encephalopathy. Failure of the blood pressure to respond to this agent should lead to consideration of the use of sodium nitroprusside. The possibility of the presence of a cathecholamine-secreting tumor should also be considered in these rare patients. In less severe cases, reserpine and hydralazine--alone or in combination--offer sufficiently rapid and prolonged action to prevent the development of encephalopathy in patients with acute elevations of blood pressure.