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Arterial Hypertension in Children

Wolfgang Rascher1, Christian Paech2

  • 1Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander - University Erlangen-Nürnberg, Erlangen, Germany. wolfgang.rascher@uk-erlangen.de.

Handbook of Experimental Pharmacology
|May 28, 2020
PubMed

Insights

Blocking the angiotensin system effectively lowers blood pressure in children, including those under six. These medications are safe for short-term use, offering a reliable treatment option for pediatric hypertension.

Area of Science:

  • Pediatric Pharmacology
  • Cardiovascular Medicine
  • Hypertension Management

Background:

  • Pharmacological treatment for pediatric arterial hypertension often relies on individual clinical experience.
  • Evidence suggests blocking the angiotensin system is effective and safe for children, even under six years old.

Purpose of the Study:

  • To review the efficacy and safety of various pharmacological agents for treating arterial hypertension in children.
  • To summarize the evidence for angiotensin system blockers, calcium channel antagonists, and beta-blockers in pediatric hypertension.

Main Methods:

  • Review of existing evidence and small-sized studies on antihypertensive medications in children.
  • Analysis of the effectiveness of angiotensin-converting enzyme inhibitors, angiotensin 1 receptor antagonists, calcium channel antagonists, and beta-blockers.

Main Results:

  • Angiotensin system blockers (ACE inhibitors, ARBs) effectively reduce systolic and diastolic blood pressure in children.
  • While effective, these agents may not show a consistent dose-response relationship, though effective doses are established.
  • Calcium channel antagonists show efficacy, but supporting evidence is limited.
  • Beta-blockers offer modest systolic blood pressure reduction without significant diastolic effects compared to placebo and can counteract reflex tachycardia.

Conclusions:

  • Pharmacological interventions, particularly those targeting the angiotensin system, provide effective treatment for pediatric hypertension.
  • Commonly used antihypertensive medications demonstrate safety for short-term use in pediatric populations.
  • Further research may be needed to solidify evidence for certain drug classes like calcium channel antagonists in children.

Keywords:
AntihypertensivesArterial hypertensionClinical trialsPediatrics

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