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 .
Safety, Efficacy, and Pharmacokinetics of Telmisartan in Pediatric Patients With Hypertension
Objective . To assess the safety , pharmacokinetics ( PKs ) , and blood pressure (BP)-lowering efficacy of telmisartan in pediatric ( 6 to < 18 years ) patients with hypertension . Study design . Patients with diagnosed hypertension were r and omized to 4 weeks of treatment with placebo , or with 1 of 2 nominal telmisartan dose levels ( 1 mg/kg/d or 2 mg/kg/d ) . The primary end point was change in seated systolic BP ( SBP ) from baseline to study end . Results . A total of 77 patients were r and omized and received at least 1 dose of study medication ( placebo , n = 16 ; low-dose telmisartan , n = 30 ; high-dose telmisartan , n = 31 ) . Adjusted mean changes ( st and ard errors ) in SBP from baseline to study end were −6 ( 2.4 ) , −14 ( 1.7 ) , and −9.7 ( 1.7 ) mm Hg , respectively , in the placebo , high-dose telmisartan , and low-dose telmisartan groups . Conclusions . Telmisartan may be an appropriate therapy for treatment of pediatric hypertension , although more extensive studies are required in patients younger than age 12
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 .