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 .
The efficacy and safety of valsartan in obese and non-obese pediatric hypertensive patients.
This post hoc analysis assessed the efficacy and tolerability of valsartan for the treatment of hypertension in obese vs non-obese children and adolescents . After a 1-week antihypertensive washout period , 142 obese and 119 non-obese hypertensive children and adolescents aged 6 to 16 years were r and omized to 2 weeks of once-daily treatment with valsartan 10 to 20 mg , 40 to 80 mg , or 80 to 160 mg , followed by re-r and omization to either valsartan or placebo for an additional 2 weeks . Patients could continue to receive valsartan during an optional 52-week , open-label extension . Valsartan result ed in statistically significant ( P<.05 ) and clinical ly relevant reductions in mean sitting blood pressure ( BP ) , ranging from approximately 7/4 mm Hg ( valsartan 10 - 20 mg ) to 13/9 mm Hg ( valsartan 80 - 160 mg ) in both obese and non-obese patients . BP control was achieved in 44 % of obese and 56 % of non-obese patients . Following re-r and omization , non-obese patients experienced an increase in BP during placebo treatment , albeit levels remained below baseline , whereas BP reductions were maintained in valsartan recipients ( P<.05 ) . The most frequent adverse events during the open-label phase were headache and fever .  Valsartan provides similar antihypertensive efficacy in obese and non-obese hypertensive children and adolescents , with good tolerability in both patient population
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 .