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Long term therapy by captopril in children with renal hypertension
Insights
Captopril effectively lowers severe renal hypertension in children, significantly reducing blood pressure within months. Combination therapy with beta blockers improved outcomes in non-responsive cases, with minimal side effects observed.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Pharmacology
Background:
- Severe renal hypertension in children poses significant health risks.
- Effective antihypertensive management is crucial for preventing long-term complications.
Purpose of the Study:
- To evaluate the efficacy and safety of captopril in treating severe renal hypertension in pediatric patients.
- To assess the impact of captopril on blood pressure reduction over time.
Main Methods:
- Retrospective analysis of 29 treatment courses in 25 children (aged 1.5-18 years) receiving captopril.
- Dosage adjustments and treatment duration were recorded.
- Blood pressure (BP) changes, etiology, hypertension (HT) degree, and plasma renin activity (PRA) were analyzed.
Main Results:
- Captopril significantly lowered systolic and diastolic BP by 26% at day 2 and 65% by month 6.
- Isolated captopril was ineffective in 13% of cases; addition of beta blockers normalized BP in all.
- No clear correlation found between BP response and HT etiology, degree, or PRA.
Conclusions:
- Captopril is an effective treatment for severe renal hypertension in children.
- Combination therapy with beta blockers enhances efficacy in non-responsive cases.
- Captopril demonstrated a favorable safety profile, with one case of reversible renal failure.
Abstract:
We report on 29 treatment courses in 25 children aged 1.5-18 years who received captopril because of severe renal hypertension. The mean initial dosage was 1.3 (0.5 to 3) mg/kg/day and the mean sustaining dose 2.2 mg/kg/day. The treatment was followed for 2-40 (mean 15) months. We observed a lowering of both systolic and diastolic blood pressure (BP) from 26% at the 2nd day to 65% at the 6th month. The isolated use of captopril was ineffective in 13% of cases, but blood pressure dropped in all of them after addition of beta blocking agents. No clear-cut relation was found between response of blood pressure and etiology, degree of HT or plasma renin activity (PRA). No side effects occurred during treatment except for one case of reversible acute renal failure in a transplanted patient with renal artery stenosis.