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[Childhood hypertension: current medical management]
G D Simonetti1, E Fossali, G P Ramelli
1Kindernephrologie und Hypertonie, Universitäts-Kinderklinik, 3000 Bern.
Insights
Pediatricians now better manage childhood hypertension, aiming to lower blood pressure below the 90th percentile. Renin-angiotensin system blockers or calcium channel blockers are favored, especially for kidney disease and diabetes.
Area of Science:
- Pediatrics
- Cardiology
- Nephrology
Context:
- Improved understanding of childhood hypertension management.
- Secondary hypertension in children requires specific therapeutic goals.
Purpose:
- To outline current best practices for antihypertensive drug therapy in pediatric secondary hypertension.
- To guide the selection of antihypertensive agents based on patient comorbidities.
Summary:
- The primary goal of antihypertensive therapy in children is to maintain blood pressure below the 90th percentile.
- Renin-angiotensin system blockers (ACE inhibitors, ARBs) and calcium channel blockers are the preferred drug classes.
- In pediatric patients with kidney disease and diabetes mellitus, renin-angiotensin system blockers are particularly recommended, especially with proteinuria.
Impact:
- Provides evidence-based guidance for pediatricians managing hypertension.
- Aims to improve long-term cardiovascular and renal outcomes in children with hypertension.
- Highlights the importance of tailored antihypertensive strategies based on underlying conditions.
Abstract:
Pediatricians currently have improved understanding of how to best manage childhood hypertension. The goal of antihypertensive drug therapy in children with secondary hypertension is currently to reduce the blood pressure below the 90th centile. Most authors currently favor therapy with a blocker of the renin-angiotensin system (a converting enzyme inhibitor or an angiotensin II antagonist) or a calcium channel blocker. In patients with kidney disease and diabetes mellitus we generally advise therapy of hypertension with a blocker of the renin-angiotensin system especially in the presence of pathological proteinuria.
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