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 .
Effectiveness and safety of valsartan in children aged 6 to 16 years with hypertension.
The effectiveness and safety of valsartan have not been assessed in hypertensive children . Therefore , hypertensive patients aged 6 to 16 years ( n=261 ) were r and omized to receive weight-stratified low- ( 10/20 mg ) , medium- ( 40/80 mg ) , or high-dose ( 80/160 mg ) valsartan for 2 weeks . After 2 weeks , patients were r and omized to a 2-week placebo-controlled withdrawal phase . Dose-dependent reductions in sitting systolic blood pressure ( SSBP ) and sitting diastolic blood pressure ( SDBP ) were observed after 2 weeks ( low dose , -7.9/-4.6 mm Hg ; medium dose , -9.6/-5.8 mm Hg ; high dose , -11.5/-7.4 mm Hg [ P<.0001 for all groups ] ) . During the withdrawal phase , SSBP and SDBP were both lower in the pooled valsartan group than in the pooled placebo group ( SSBP , -2.7 mm Hg [ P=.0368 ] ; SDBP , -3.0 mm Hg [ P=.0047 ] ) . Similar efficacy was observed in all subgroups . Valsartan was well tolerated and headache was the most commonly observed adverse event during both the double-blind and 52-week open-label phases
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 .