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 .
Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure.
OBJECTIVES To determine the association between carotid artery intimal-medial thickness ( cIMT ) and left ventricular mass index ( LVMI ) in children with elevated blood pressure . METHODS Study subjects ( n = 32 ; mean age : 13.9 + /- 2.7 years ) were untreated new referrals to a pediatric hypertension clinic with confirmed elevated blood pressure . LVM was calculated from 2-dimensionally guided m-mode echocardiographic measurements of the left ventricle . LVMI was calculated as LVM (g)/height (m)2.7 , and left ventricular hypertrophy ( LVH ) was defined as LVMI > 95th percentile . Carotid artery duplex ultrasound was performed by protocol by experienced vascular sonographers who were unaware of the echocardiography results . The thickest IMT complex of the far wall of the distal common carotid artery was measured in longitudinal B-mode section using a high-resolution linear array of 8 MHz . RESULTS The prevalence of LVH and increased cIMT was 41 % and 28 % , respectively . Subjects with increased cIMT had higher LVMI ( 46.8 g/m2.7 vs 31.4 g/m2.7 ) than those with normal cIMT . The LVH prevalence was 89 % ( 8 of 9 ) among subjects with increased cIMT as compared with 22 % ( 5 of 23 ) in subjects with normal cIMT . cIMT was positively correlated with body mass index ( r = 0.43 ) , interventricular septal thickness ( r = 0.58 ) , posterior wall thickness ( r = 0.54 ) , and LVMI ( r = 0.54 ) . cIMT and LVMI were positively associated after accounting for age , gender , and body mass index . CONCLUSIONS These findings raise the possibility that carotid duplex ultrasound , by indicating the presence of early arterial wall changes , may be useful for predicting other cardiovascular sequelae in hypertensive 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 .