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Efficacy and safety of valsartan compared to enalapril in hypertensive children: a 12-week, randomized,

Franz Schaefer1, Mieczyslaw Litwin, Jacek Zachwieja

  • 1Division of Paediatric Nephrology, Centre for Paediatric and Adolescent Medicine, University Hospital of Heidelberg, ImNeuenheimer Feld, Germany. franz.schaefer@med.uni-heidelberg.de

Journal of Hypertension
|October 26, 2011
PubMed

Insights

Valsartan and enalapril are equally effective and safe for treating high blood pressure (hypertension) in children aged 6-17. Both medications demonstrated comparable blood pressure reductions and were well-tolerated, offering effective hypertension management in pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Pediatric hypertension is a growing concern with significant long-term cardiovascular implications.
  • Limited data exists comparing the efficacy and safety of different antihypertensive agents in children.
  • Valsartan and enalapril are commonly prescribed, but direct comparative studies in pediatric populations are needed.

Purpose of the Study:

  • To compare the efficacy and safety of valsartan versus enalapril in hypertensive children aged 6-17 years.
  • To assess noninferiority of valsartan to enalapril based on mean sitting systolic blood pressure (MSSBP) reduction.
  • To evaluate other efficacy parameters including diastolic blood pressure, blood pressure control rates, and 24-hour ambulatory blood pressure monitoring.

Main Methods:

  • A 12-week, randomized, double-blind, parallel-group, active-controlled study design.
  • Inclusion of children aged 6-17 years with MSSBP at or above the 95th percentile for age, gender, and height.
  • Force-titration of valsartan and enalapril to full doses over 11 weeks following a placebo run-in period.

Main Results:

  • Valsartan demonstrated noninferiority to enalapril in reducing MSSBP (P < 0.0001).
  • Both drugs achieved similar reductions in MSSBP (-15.4/-9.4 mmHg for valsartan vs. -14.1/-8.5 mmHg for enalapril) and blood pressure control rates (67% vs. 70%).
  • Valsartan showed a statistically significant greater reduction in mean 24-hour systolic blood pressure compared to enalapril (P = 0.03).

Conclusions:

  • Valsartan and enalapril are comparable in efficacy and safety for treating hypertension in children aged 6-17.
  • Both antihypertensive agents provide effective blood pressure control and are well-tolerated in the pediatric population.
  • The findings support the use of both valsartan and enalapril as therapeutic options for pediatric hypertension.
Abstract

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