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Hypertensive urgency – nifedipine — RACP Paediatrics MCQ

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ModerateNephrologyHypertensive urgency – nifedipineRACP Paediatrics

A 12-year-old has severe hypertension (BP 170/105 mmHg) with headache but no papilloedema, visual changes, or encephalopathy. This is classified as hypertensive urgency. What is the most appropriate initial treatment?

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Correct answer: D — Oral nifedipine

Hypertensive urgency (severe hypertension without end-organ damage) can be treated with oral antihypertensives with gradual BP reduction over 24-48 hours. Oral nifedipine (short-acting, 0.25-0.5 mg/kg) is commonly used for acute BP reduction. Sublingual nifedipine should NOT be used as it can cause unpredictable hypotension.

Reference: RCH Melbourne – 2024 – Hypertension CPG; RACP Paediatric Curriculum – Nephrology