The adverse events associated with the antihypertensive agents were mostly minor and included headaches , dizziness and upper respiratory infections .
The most data are available for c and esartan , for which there is low- quality evidence of a modest lowering effect on blood pressure .
We did not find evidence of a consistent dose response relationship for escalating doses of angiotensin receptor blockers , calcium channel blockers or angiotensin-converting enzyme inhibitors .
All agents appear safe , at least in the short term
BACKGROUND Hypertension is a major risk factor for stroke , coronary artery disease and kidney damage in adults .
There is a paucity of data on the long-term sequelae of persistent hypertension in children , but it is known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood .
The prevalence of hypertension in children is rising , most likely due to a concurrent rise in obesity rates .
In children with hypertension , non-pharmacological measures are often recommended as first-line therapy , but a significant proportion of children will eventually require pharmacological treatment to reduce blood pressure , especially those with evidence of end organ damage at presentation or during follow-up .
A systematic review of the effects of antihypertensive agents in children has not previously been conducted .
OBJECTIVES To determine the dose-related effects of different classes of antihypertensive medications , as monotherapy compared to placebo ; as combination therapy compared to placebo or a single medication ; or in comparisons of various doses within the same class , on systolic or diastolic blood pressure ( or both ) in children with hypertension .
Efficacy and safety of extended release metoprolol succinate in hypertensive children 6 to 16 years of age: a clinical trial experience.
OBJECTIVE To evaluate the efficacy , tolerability , and blood pressure ( BP ) lowering effect of extended release metoprolol succinate ( ER metoprolol ) in children 6 to 16 years of age with established hypertension . STUDY DESIGN Patients were r and omized to one of four treatment arms : placebo or ER metoprolol ( 0.2 mg/kg , 1.0 mg/kg , or 2.0 mg/kg ) . Data were analyzed on 140 intent-to-treat patients . RESULTS Mean age ( + /-SD ) was 12.5 + /- 2.8 years and mean baseline BP was 132/78 + /- 9/9 mmHg . Following 4 weeks of treatment , mean changes in sitting BP were : placebo = -1.9/-2.1 mmHg ; ER metoprolol 0.2 mg/kg = -5.2/-3.1 mmHg ; 1.0 mg/kg = -7.7/-4.9 mmHg ; 2.0 mg/kg = -6.3/-7.5 mmHg . Compared with placebo , ER metoprolol significantly reduced systolic blood pressure ( SBP ) at the 1.0 and 2.0 mg/kg dose ( P = .027 and P = .049 , respectively ) , reduced diastolic blood pressure ( DBP ) at the 2.0 mg/kg dose ( P = .017 ) , and showed a statistically significant dose response relationship for the placebo-corrected change in DBP from baseline . There were no serious adverse events or adverse events requiring study drug discontinuation among patients receiving active therapy . CONCLUSION These data indicate that ER metoprolol is an effective and well-tolerated treatment for hypertension in children
The adverse events associated with the antihypertensive agents were mostly minor and included headaches , dizziness and upper respiratory infections .
The most data are available for c and esartan , for which there is low- quality evidence of a modest lowering effect on blood pressure .
We did not find evidence of a consistent dose response relationship for escalating doses of angiotensin receptor blockers , calcium channel blockers or angiotensin-converting enzyme inhibitors .
All agents appear safe , at least in the short term
BACKGROUND Hypertension is a major risk factor for stroke , coronary artery disease and kidney damage in adults .
There is a paucity of data on the long-term sequelae of persistent hypertension in children , but it is known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood .
The prevalence of hypertension in children is rising , most likely due to a concurrent rise in obesity rates .
In children with hypertension , non-pharmacological measures are often recommended as first-line therapy , but a significant proportion of children will eventually require pharmacological treatment to reduce blood pressure , especially those with evidence of end organ damage at presentation or during follow-up .
A systematic review of the effects of antihypertensive agents in children has not previously been conducted .
OBJECTIVES To determine the dose-related effects of different classes of antihypertensive medications , as monotherapy compared to placebo ; as combination therapy compared to placebo or a single medication ; or in comparisons of various doses within the same class , on systolic or diastolic blood pressure ( or both ) in children with hypertension .