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 .
[Evaluation of the efficacy and tolerance of three antihypertensive agents used as single-drug therapy, nifedipine, prazosin and acebutolol in severe, idiopathic hypertension in adolescents].
The antihypertensive efficacy of single-drug therapy with nifedipine ( N ) , prazosin ( P ) , or acebutolol ( A ) and the influence of these agents on coronary risk factors including hypoglycemia , hyperuricemia , and hyperlipidemia , were studied in adolescents with hypertension . Ninety patients ( 73 girls and 17 boys ) aged 14 to 18 years with idiopathic hypertension ( IH ) were r and omized into three groups . Each group received N , P , or A as single-drug therapy for six months . Systolic and diastolic blood pressures fell in all three groups , from 152/90 mmHg to 127/70 mmHg * with N , from 150/90 mmHg to 121/70 mmHg * with P , and from 148/92 mmHg to 122/74 mmHg * mmHg with A. In 17 % of cases , N failed to reduce blood pressures below the 90th centiles . Heart rate was not influenced by N or P but decreased from 84 to 75 bpm with A. Although none of the drugs modified serum uric acid levels , fractional uric acid secretion rose with P and A ( from 4.1 % to 6 % with P ; and from 4.4 % to 6 % with A ) . The lipid profile remained unchanged under N and P , whereas a decrease in serum LDL-cholesterol from 99.6 to 88.8 % mg * was seen with A. Fasting serum glucose levels increased from 86.4 to 92.7 mg % * in the group given A. N , P , and A are suitable for single-drug therapy of IH in adolescents ; the most appropriate drug should be selected on the basis of medical history
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 .