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Pharmacologic Treatment of Pediatric Hypertension

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Pediatric Hypertension

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Abstract

Hypertension has traditionally been regarded as a rare occurrence in childhood and adolescence; however, there is compelling evidence to suggest that elevated blood pressure is increasingly common in this population, in part due to the rising prevalence of obesity. As a result, pediatricians increasingly are expected to evaluate and manage patients with elevated blood pressure. An increased emphasis on conducting drug trials in children over the last three decades has yielded important advances with respect to evidence-based data regarding the safety and efficacy of antihypertensive medications in children and adolescents. Despite these advances, data to definitively guide the selection of first-line antihypertensive agents is lacking. This chapter provides an overview of antihypertensive drug therapy in children, including indications for treatment. A detailed review of available antihypertensive agents is provided with an emphasis on pediatric specific data with respect to dosing, safety, and efficacy. In addition, a rational approach to selecting an appropriate medication with respect to pathophysiology, putative benefit, and likelihood for side effects is reviewed.

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References

  • Alderman MH, Cohen HW, Sealey JE, Laragh JH (2010) Pressor responses to antihypertensive drug types. Am J Hypertens 23(9):1031–1037. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Allcock DM, Sowers JR (2010) Best strategies for hypertension management in type 2 diabetes and obesity. Curr Diab Rep 10(2):139–144. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Andersen J, Groshong T, Tobias JD (2006) Preliminary experience with amlodipine in the pediatric population. Am J Ther 13(3):198–204. PubMed

    Article  PubMed  Google Scholar 

  • Bachmann H (1984) Propranolol versus chlorthalidone – a prospective therapeutic trial in children with chronic hypertension. Helv Paediatr Acta 39(1):55–61. PubMed

    CAS  PubMed  Google Scholar 

  • Batisky DL (2012) What is the optimal first-line agent in children requiring antihypertensive medication? Curr Hypertens Rep 14(6):603–607. PubMed

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Batisky DL, Sorof JM, Sugg J, Llewellyn M, Klibaner M, Hainer JW, Portman RJ, Falkner B (2007) Efficacy and safety of extended release metoprolol succinate in hypertensive children 6 to 16 years of age: a clinical trial experience. J Pediatr 150(2):134–139,e131. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Benjamin DK Jr, Smith PB, Jadhav P, Gobburu JV, Murphy MD, Hasselblad V, Baker-Smith C, Califf RM, Li JS (2008) Pediatric antihypertensive trial failures: analysis of end points and dose range. Hypertension 51(4):834–840. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Blaszak RT, Savage JA, Ellis EN (2001) The use of short-acting nifedipine in pediatric patients with hypertension. J Pediatr 139(1):34–37. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Blowey DL (2012) Update on the pharmacologic treatment of hypertension in pediatrics. J Clin Hypertens (Greenwich) 14(6):383–387

    Article  CAS  Google Scholar 

  • Blumenthal S, Epps RP, Heavenrich R, Lauer RM, Lieberman E, Mirkin B, Mitchell SC, Boyar Naito V, O’Hare D, McFate Smith W, Tarazi RC, Upson D (1977) Report of the task force on blood pressure control in children. Pediatrics 59(5 2 Suppl):I–II. 797–820. PubMed

    CAS  PubMed  Google Scholar 

  • Boneparth A, Flynn JT (2009) Evaluation and treatment of hypertension in general pediatric practice. Clin Pediatr (Phila) 48(1):44–49

    Article  Google Scholar 

  • Brewster LM, van Montfrans GA, Kleijnen J (2004) Systematic review: antihypertensive drug therapy in black patients. Ann Intern Med 141(8):614–627. PubMed

    Article  PubMed  Google Scholar 

  • Brili S, Tousoulis D, Antoniades C, Vasiliadou C, Karali M, Papageorgiou N, Ioakeimidis N, Marinou K, Stefanadi E, Stefanadis C (2008) Effects of ramipril on endothelial function and the expression of proinflammatory cytokines and adhesion molecules in young normotensive subjects with successfully repaired coarctation of aorta: a randomized cross-over study. J Am Coll Cardiol 51(7):742–749. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Brown NJ, Vaughan DE (1998) Angiotensin-converting enzyme inhibitors. Circulation 97(14):1411–1420. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Bullo M, Tschumi S, Bucher BS, Bianchetti MG, Simonetti GD (2012) Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists: a systematic review. Hypertension 60(2):444–450. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Caballero AE (2003) Endothelial dysfunction in obesity and insulin resistance: a road to diabetes and heart disease. Obes Res 11(11):1278–1289. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Chaturvedi S, Lipszyc DH, Licht C, Craig JC, Parekh R (2014) Pharmacological interventions for hypertension in children. Cochrane Database Syst Rev 2(CD008117)

    Google Scholar 

  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ (2003) Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42(6):1206–1252

    Article  CAS  PubMed  Google Scholar 

  • Crippa C, Bergonzi M, Bravi E, Balordi V, Cassi A (2018) Effect of electronic cigarette smoking on blood pressure in hypertensive patients. Evaluation by non-invasive continuous ambulatory blood pressure measurement. J Hyper. https://doi.org/10.1097/01.hjh.0000538974.96760.a3

  • Daniels SR, Loggie JM, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97(19):1907–1911. PubMed

    Article  CAS  PubMed  Google Scholar 

  • DiBianco R (1985) Angiotensin converting enzyme inhibition. Unique and effective therapy for hypertension and congestive heart failure. Postgrad Med 78(5):229–241. 244, 247–228 PubMed

    Article  CAS  PubMed  Google Scholar 

  • Dilmen U, Caglar MK, Senses DA, Kinik E (1983) Nifedipine in hypertensive emergencies of children. Am J Dis Child 137(12):1162–1165. PubMed

    CAS  PubMed  Google Scholar 

  • Din-Dzietham R, Liu Y, Bielo MV, Shamsa F (2007) High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 116(13):1488–1496

    Article  PubMed  Google Scholar 

  • Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Whittle L, Lim C, Wechsler H (2012) Youth risk behavior surveillance – United States, 2011. MMWR Surveill Summ 61(4):1–162. PubMed

    PubMed  Google Scholar 

  • Egan BM, Basile JN, Rehman SU, Davis PB, Grob CH 3rd, Riehle JF, Walters CA, Lackland DT, Merali C, Sealey JE, Laragh JH (2009) Plasma renin test-guided drug treatment algorithm for correcting patients with treated but uncontrolled hypertension: a randomized controlled trial. Am J Hypertens 22(7):792–801. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Egger DW, Deming DD, Hamada N, Perkin RM, Sahney S (2002) Evaluation of the safety of short-acting nifedipine in children with hypertension. Pediatr Nephrol 17(1):35–40. PubMed

    Article  PubMed  Google Scholar 

  • Evans JH, Shaw NJ, Brocklebank JT (1988) Sublingual nifedipine in acute severe hypertension. Arch Dis Child 63(8):975–977. PubMed

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report (2011) Pediatrics 128(Suppl 5):S213–S256

    Google Scholar 

  • Fagard RH (2007) Athletes with systemic hypertension. Cardiol Clin 25(3):441–448, vii. PubMed

    Article  PubMed  Google Scholar 

  • Falkner B, Onesti G, Lowenthal DT, Affrime MB (1983) The use of clonidine monotherapy in adolescent hypertension. Chest 83(Suppl 2):425–427. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Fixler DE, Laird WP, Fitzgerald V, Stead S, Adams R (1979) Hypertension screening in schools: results of the Dallas study. Pediatrics 63(1):32–36. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT (2002) Nifedipine in the treatment of hypertension in children. J Pediatr 140(6):787–788. PubMed

    Article  PubMed  Google Scholar 

  • Flynn JT (2005) Efficacy and safety of prolonged amlodipine treatment in hypertensive children. Pediatr Nephrol 20(5):631–635. PubMed

    Article  PubMed  Google Scholar 

  • Flynn JT, Daniels SR (2006) Pharmacologic treatment of hypertension in children and adolescents. J Pediatr 149(6):746–754. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT, Warnick SJ (2002) Isradipine treatment of hypertension in children: a single-center experience. Pediatr Nephrol 17(9):748–753

    Article  PubMed  Google Scholar 

  • Flynn JT, Smoyer WE, Bunchman TE (2000) Treatment of hypertensive children with amlodipine. Am J Hypertens 13(10):1061–1066. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT, Newburger JW, Daniels SR, Sanders SP, Portman RJ, Hogg RJ, Saul JP (2004) A randomized, placebo-controlled trial of amlodipine in children with hypertension. J Pediatr 145(3):353–359. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT, Nahata MC, Mahan JD Jr, Portman RJ (2006) Population pharmacokinetics of amlodipine in hypertensive children and adolescents. J Clin Pharmacol 46(8):905–916. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT, Mitsnefes M, Pierce C, Cole SR, Parekh RS, Furth SL, Warady BA (2008) Blood pressure in children with chronic kidney disease: a report from the chronic kidney disease in children study. Hypertension 52(4):631–637. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Flynn JT, Kaelber DC, Baker-Smith CM et al (2017) Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140(3):e20171904

    Article  PubMed  Google Scholar 

  • Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and nutrition examination survey. JAMA 287(3):356–359

    Article  PubMed  Google Scholar 

  • Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH (2008) Prevalence of the metabolic syndrome among U.S. adolescents using the definition from the International Diabetes Federation. Diabetes Care 31(3):587–589. PubMed

    Article  PubMed  Google Scholar 

  • Franscini LM, Von Vigier RO, Pfister R, Casaulta-Aebischer C, Fossali E, Bianchetti MG (2002) Effectiveness and safety of the angiotensin II antagonist irbesartan in children with chronic kidney diseases. Am J Hypertens 15(12):1057–1063. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Friedman DB, Musch TI, Williams RS, Ordway GA (1987) Beta adrenergic blockade with propranolol and atenolol in the exercising dog: evidence for beta 2 adrenoceptors in the sinoatrial node. Cardiovasc Res 21(2):124–129. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Garovic V, Textor SC (2005a) Renovascular hypertension: current concepts. Semin Nephrol 25(4):261–271. PubMed

    Article  PubMed  Google Scholar 

  • Garovic VD, Textor SC (2005b) Renovascular hypertension and ischemic nephropathy. Circulation 112(9):1362–1374. PubMed

    Article  PubMed  Google Scholar 

  • Gidding SS, Rocchini AP, Beekman R, Szpunar CA, Moorehead C, Behrendt D, Rosenthal A (1985) Therapeutic effect of propranolol on paradoxical hypertension after repair of coarctation of the aorta. N Engl J Med 312(19):1224–1228. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Gordon JF (1973) Detection of hypertension in childhood. Br Med J 3(5880):591

    Google Scholar 

  • Goulet C, Valois P, Buist A, Cote M (2010) Predictors of the use of performance-enhancing substances by young athletes. Clin J Sport Med 20(4):243–248. PubMed

    Article  PubMed  Google Scholar 

  • Griswold WR, McNeal R, Mendoza SA, Sellers BB, Higgins S (1978) Propranolol as an antihypertensive agent in children. Arch Dis Child 53(7):594–596. PubMed

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Grossman E, Messerli FH, Grodzicki T, Kowey P (1996) Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies? JAMA 276(16):1328–1331. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Hanevold C, Waller J, Daniels S, Portman R, Sorof J (2004) The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics 113(2):328–333

    Article  PubMed  Google Scholar 

  • Hazan L, Hernandez Rodriguez OA, Bhorat AE, Miyazaki K, Tao B, Heyrman R (2010) A double-blind, dose-response study of the efficacy and safety of olmesartan medoxomil in children and adolescents with hypertension. Hypertension 55(6):1323–1330. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Hornsby JL, Mongan PF, Taylor AT, Treiber FA (1991) “White coat” hypertension in children. J Fam Pract 33(6):617–623. PubMed

    CAS  PubMed  Google Scholar 

  • Iseki K, Ikemiya Y, Iseki C, Takishita S (2003) Proteinuria and the risk of developing end-stage renal disease. Kidney Int 63(4):1468–1474. PubMed

    Article  PubMed  Google Scholar 

  • Jacobs T, Salisbury B, Terrell J (2021) Aliskiren. Stat Pearls

    Google Scholar 

  • Jafar TH, Schmid CH, Landa M, Giatras I, Toto R, Remuzzi G, Maschio G, Brenner BM, Kamper A, Zucchelli P, Becker G, Himmelmann A, Bannister K, Landais P, Shahinfar S, de Jong PE, de Zeeuw D, Lau J, Levey AS (2001) Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data. Ann Intern Med 135(2):73–87. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Johansson M, Friberg P (2000) Role of the sympathetic nervous system in human renovascular hypertension. Curr Hypertens Rep 2(3):319–326. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Johnson CE, Jacobson PA, Song MH (1997) Isradipine therapy in hypertensive pediatric patients. Ann Pharmacother 31(6):704–707. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Kaplan NM, Victor RG (2010) Clinical hypertension, 10th edn. Lippincott Williams and Wilkins, New York

    Google Scholar 

  • Kenny D, Hijazi ZM (2011) Coarctation of the aorta: from fetal life to adulthood. Cardiol J 18(5):487–495. PubMed

    Article  PubMed  Google Scholar 

  • Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J (1996) Blood pressure and end-stage renal disease in men. N Engl J Med 334(1):13–18. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Kollias A, Skliros E, Stergiou GS, Leotsakos N, Saridi M, Garifallos D (2011) Obesity and associated cardiovascular risk factors among schoolchildren in Greece: a cross-sectional study and review of the literature. J Pediatr Endocrinol Metab 24(11–12):929–938. PubMed

    PubMed  Google Scholar 

  • Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, Sowers J (2013) Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of the obesity society and the American society of hypertension. J Clin Hypertens (Greenwich) 15(1):14–33

    Article  CAS  Google Scholar 

  • Laragh J (2001) Laragh’s lessons in pathophysiology and clinical pearls for treating hypertension. Am J Hypertens 14(9 Pt 1):837–854. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Laragh JH, Sealey JE (2011) The plasma renin test reveals the contribution of body sodium-volume content (V) and renin-angiotensin (R) vasoconstriction to long-term blood pressure. Am J Hypertens 24(11):1164–1180. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Lazzeri G, Rossi S, Pammolli A, Pilato V, Pozzi T, Giacchi MV (2008) Underweight and overweight among children and adolescents in Tuscany (Italy). Prevalence and short-term trends. J Prev Med Hyg 49(1):13–21. PubMed

    CAS  PubMed  Google Scholar 

  • Lewington S, Clarke R, Qizilbash N, Peto R, Collins R (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360(9349):1903–1913. PubMed

    Article  PubMed  Google Scholar 

  • Li JS, Berezny K, Kilaru R, Hazan L, Portman R, Hogg R, Jenkins RD, Kanani P, Cottrill CM, Mattoo TK, Zharkova L, Kozlova L, Weisman I, Deitchman D, Califf RM (2004) Is the extrapolated adult dose of fosinopril safe and effective in treating hypertensive children? Hypertension 44(3):289–293. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Li JS, Flynn JT, Portman R, Davis I, Ogawa M, Shi H, Pressler ML (2010) The efficacy and safety of the novel aldosterone antagonist eplerenone in children with hypertension: a randomized, double-blind, dose-response study. J Pediatr 157(2):282–287

    Article  CAS  PubMed  Google Scholar 

  • Locatelli F, Marcelli D, Comelli M, Alberti D, Graziani G, Buccianti G, Redaelli B, Giangrande A (1996) Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Northern Italian Cooperative Study Group. Nephrol Dial Transplant 11(3):461–467. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Loggie JM (1969) Hypertension in children and adolescents. II Drug therapy J Pediatr 74(4):640–654. PubMed

    CAS  PubMed  Google Scholar 

  • Loggie J (1973) Letter: detection of hypertension in childhood. Br Med J 4(5888):356. PubMed

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Londe S (1968) Blood pressure standards for normal children as determined under office conditions. Clin Pediatr 7(7):400–403

    Article  CAS  Google Scholar 

  • Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, Invitti C, Litwin M, Mancia G, Pall D, Rascher W, Redon J, Schaefer F, Seeman T, Sinha M, Stabouli S, Webb NJ, Wuhl E, Zanchetti A (2016) 2016 European Society of Hypertension Guidelines for the management of high blood pressure in children and adolescents. J Hypertens 34(10):1887–1920. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Lyszkiewicz DA, Levichek Z, Kozer E, Yagev Y, Moretti M, Hard M, Koren G (2003) Bioavailability of a pediatric amlodipine suspension. Pediatr Nephrol 18(7):675–678. PubMed

    Article  PubMed  Google Scholar 

  • Mancia G, Grassi G, Zanchetti A (2006) New-onset diabetes and antihypertensive drugs. J Hypertens 24(1):3–10. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Manrique C, Giles TD, Ferdinand KC, Sowers JR (2009) Realities of newer beta-blockers for the management of hypertension. J Clin Hypertens (Greenwich) 11(7):369–375

    Article  CAS  Google Scholar 

  • Maron BJ, Zipes DP (2005) Introduction: eligibility recommendations for competitive athletes with cardiovascular abnormalities-general considerations. J Am Coll Cardiol 45(8):1318–1321. PubMed

    Article  PubMed  Google Scholar 

  • Maschio G, Alberti D, Janin G, Locatelli F, Mann JF, Motolese M, Ponticelli C, Ritz E, Zucchelli P (1996) Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The angiotensin-converting-enzyme inhibition in progressive renal insufficiency study group. N Engl J Med 334(15):939–945. PubMed

    Article  CAS  PubMed  Google Scholar 

  • McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ (2007) Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 150(6):640–644 e641

    Article  PubMed  Google Scholar 

  • Menon S, Berezny KY, Kilaru R, Benjamin DK Jr, Kay JD, Hazan L, Portman R, Hogg R, Deitchman D, Califf RM, Li JS (2006) Racial differences are seen in blood pressure response to fosinopril in hypertensive children. Am Heart J 152(2):394–399. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Meyers RS, Siu A (2011) Pharmacotherapy review of chronic pediatric hypertension. Clin Ther 33(10):1331–1356. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Midha T, Nath B, Kumari R, Rao YK, Pandey U (2012) Childhood obesity in India: a meta-analysis. Indian J Pediatr 79(7):945–948. PubMed

    Article  PubMed  Google Scholar 

  • Mirkin BL, Newman TJ (1985) Efficacy and safety of captopril in the treatment of severe childhood hypertension: report of the International Collaborative Study Group. Pediatrics 75(6):1091–1100. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Miyashita Y, Peterson D, Rees JM, Flynn JT (2010) Isradipine for treatment of acute hypertension in hospitalized children and adolescents. J Clin Hypertens (Greenwich) 12(11):850–855

    Article  CAS  Google Scholar 

  • Moncica I, Oh PI, ul Qamar I, Scolnik D, Arbus GS, Hebert D, Balfe JW, Koren G (1995) A crossover comparison of extended release felodipine with prolonged action nifedipine in hypertension. Arch Dis Child 73(2):154–156. PubMed

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Moss AJ, Adams FH (1962) Problems of blood pressure in childhood. Charles C Thomas, Springfield

    Google Scholar 

  • Muntner P, He J, Cutler JA, Wildman RP, Whelton PK (2004) Trends in blood pressure among children and adolescents. JAMA 291(17):2107–2113. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Murakami K, Wada J, Ogawa D, Horiguchi CS, Miyoshi T, Sasaki M, Uchida HA, Nakamura Y, Makino H (2013) The effects of telmisartan treatment on the abdominal fat depot in patients with metabolic syndrome and essential hypertension: abdominal fat depot intervention Program of Okayama (ADIPO). Diab Vasc Dis Res 10(1):93–96. PubMed

    Article  PubMed  CAS  Google Scholar 

  • Nahata MC, Morosco RS, Hipple TF (1999) Stability of amlodipine besylate in two liquid dosage forms. J Am Pharm Assoc 39(3):375–377

    CAS  Google Scholar 

  • NHBPEP (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114(2 Suppl 4th Report):555–576

    Google Scholar 

  • Oberfield SE, Case DB, Levine LS, Rapaport R, Rauh W, New MI (1979) Use of the oral angiotensin I – converting enzyme inhibitor (captopril) in childhood malignant hypertension. J Pediatr 95(4):641–644. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity in the United States, 2009–2010. NCHS data brief, no. 82. National Center for Health Statistics. http://www.cdc.gov/nchs/data/databriefs/db82.pdf. Accessed 18 Jan 2013

  • Pasquali SK, Sanders SP, Li JS (2002) Oral antihypertensive trial design and analysis under the pediatric exclusivity provision. Am Heart J 144(4):608–614. PubMed

    Article  PubMed  Google Scholar 

  • Pedersen ME, Cockcroft JR (2007) The vasodilatory beta-blockers. Curr Hypertens Rep 9(4):269–277. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J (1999) The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 341(10):709–717. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M (2003) Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 348(14):1309–1321. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Prabhakar SS (2013) Inhibition of renin-angiotensin system: implications for diabetes control and prevention. J Investig Med 61(3):551–557. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Prichard BN, Cruickshank JM, Graham BR (2001) Beta-adrenergic blocking drugs in the treatment of hypertension. Blood Press 10(5–6):366–386. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Puri HC, Maltz HE, Kaiser BA, Potter DE (1983) Severe hypertension in children with renal disease: treatment with minoxidil. Am J Kidney Dis 3(1):71–75. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Ram CV (2008) Angiotensin receptor blockers: current status and future prospects. Am J Med 121(8):656–663. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Roberts J, Maurer K (1977) Blood pressure levels of persons 6–74 years. United States, 1971–1974. Vital Health Stat 11(203):i–v. 1–103

    Google Scholar 

  • Robinson RF, Nahata MC, Batisky DL, Mahan JD (2005) Pharmacologic treatment of chronic pediatric hypertension. Paediatr Drugs 7(1):27–40. PubMed

    Article  PubMed  Google Scholar 

  • Rogan JW, Lyszkiewicz DA, Blowey D, Khattak S, Arbus GS, Koren G (2000) A randomized prospective crossover trial of amlodipine in pediatric hypertension. Pediatr Nephrol 14(12):1083–1087. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Roth B, Herkenrath P, Krebber J, Abu-Chaaban M (1986) Nifedipine in hypertensive crises of infants and children. Clin Exp Hypertens A 8(4–5):871–877. PubMed

    CAS  PubMed  Google Scholar 

  • Sakarcan A, Tenney F, Wilson JT, Stewart JJ, Adcock KG, Wells TG, Vachharajani NN, Hadjilambris OW, Slugg P, Ford NF, Marino MR (2001) The pharmacokinetics of irbesartan in hypertensive children and adolescents. J Clin Pharmacol 41(7):742–749. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Samuel JP, Tyson JE, Green C, Bell CS, Pedroza C, Molony D, Samuels J (2019) Treating hypertension in children with n-of-1 Trials. Pediatrics 143(4):e20181818. PubMed

    Article  PubMed  Google Scholar 

  • Samuels J, Ng D, Flynn JT, Mitsnefes M, Poffenbarger T, Warady BA, Furth S (2012) Ambulatory blood pressure patterns in children with chronic kidney disease. Hypertension 60(1):43–50. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sarzani R, Salvi F, Dessi-Fulgheri P, Rappelli A (2008) Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J Hypertens 26(5):831–843. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Schaefer F, van de Walle J, Zurowska A, Gimpel C, van Hoeck K, Drozdz D, Montini G, Bagdasorova IV, Sorof J, Sugg J, Teng R, Hainer JW (2010) Efficacy, safety and pharmacokinetics of candesartan cilexetil in hypertensive children from 1 to less than 6 years of age. J Hypertens 28(5):1083–1090. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Schaefer F, Litwin M, Zachwieja J, Zurowska A, Turi S, Grosso A, Pezous N, Kadwa M (2011) Efficacy and safety of valsartan compared to enalapril in hypertensive children: a 12-week, randomized, double-blind, parallel-group study. J Hypertens 29(12):2484–2490. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Schiffrin EL (2006) Effects of aldosterone on the vasculature. Hypertension 47(3):312–318

    Article  CAS  PubMed  Google Scholar 

  • Schillaci G, Pirro M, Vaudo G, Gemelli F, Marchesi S, Porcellati C, Mannarino E (2004) Prognostic value of the metabolic syndrome in essential hypertension. J Am Coll Cardiol 43(10):1817–1822

    Article  PubMed  Google Scholar 

  • Shahinfar S, Cano F, Soffer BA, Ahmed T, Santoro EP, Zhang Z, Gleim G, Miller K, Vogt B, Blumer J, Briazgounov I (2005) A double-blind, dose-response study of losartan in hypertensive children. Am J Hypertens 18(2 Pt 1):183–190

    Article  CAS  PubMed  Google Scholar 

  • Sharma AM (2008) Does it matter how blood pressure is lowered in patients with metabolic risk factors? J Am Soc Hypertens 2(Suppl 4):S23–S29. PubMed

    Article  PubMed  Google Scholar 

  • Siegler RL, Brewer ED (1988) Effect of sublingual or oral nifedipine in the treatment of hypertension. J Pediatr 112(5):811–813. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Silverstein DM, Palmer J, Baluarte HJ, Brass C, Conley SB, Polinsky MS (1999) Use of calcium-channel blockers in pediatric renal transplant recipients. Pediatr Transplant 3(4):288–292. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Simonetti GD, Rizzi M, Donadini R, Bianchetti MG (2007) Effects of antihypertensive drugs on blood pressure and proteinuria in childhood. J Hypertens 25(12):2370–2376. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sinaiko AR, Mirkin BL (1977) Management of severe childhood hypertension with minoxidil: a controlled clinical study. J Pediatr 91(1):138–142. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sinaiko AR, Mirkin BL, Hendrick DA, Green TP, O’Dea RF (1983) Antihypertensive effect and elimination kinetics of captopril in hypertensive children with renal disease. J Pediatr 103(5):799–805. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sinaiko AR, Kashtan CE, Mirkin BL (1986) Antihypertensive drug therapy with captopril in children and adolescents. Clin Exp Hypertens A 8(4–5):829–839. PubMed

    CAS  PubMed  Google Scholar 

  • Sinaiko AR, Gomez-Marin O, Prineas RJ (1989) Prevalence of “significant” hypertension in junior high school-aged children: the children and adolescent blood pressure program. J Pediatr 114(4 Pt 1):664–669. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Smith CG, Vane JR (2003) The discovery of captopril. FASEB J 17(8):788–789. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Soffer B, Zhang Z, Miller K, Vogt BA, Shahinfar S (2003) A double-blind, placebo-controlled, dose-response study of the effectiveness and safety of lisinopril for children with hypertension. Am J Hypertens 16(10):795–800. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sorof JM, Portman RJ (2000) White coat hypertension in children with elevated casual blood pressure. J Pediatr 137(4):493–497. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Sorof JM, Cargo P, Graepel J, Humphrey D, King E, Rolf C, Cunningham RJ (2002) Beta-blocker/thiazide combination for treatment of hypertensive children: a randomized double-blind, placebo-controlled trial. Pediatr Nephrol 17(5):345–350. PubMed

    Article  PubMed  Google Scholar 

  • Sorof JM, Alexandrov AV, Cardwell G, Portman RJ (2003) Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics 111(1):61–66

    Google Scholar 

  • Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ (2004) Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 113(3 Pt 1):475–482

    Article  PubMed  Google Scholar 

  • Strauser LM, Groshong T, Tobias JD (2000) Initial experience with isradipine for the treatment of hypertension in children. South Med J 93(3):287–293. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Strife CF, Quinlan M, Waldo FB, Fryer CJ, Jackson EC, Welch TR, McEnery PT, West CD (1986) Minoxidil for control of acute blood pressure elevation in chronically hypertensive children. Pediatrics 78(5):861–865. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Swartz SJ, Srivaths PR, Croix B, Feig DI (2008) Cost-effectiveness of ambulatory blood pressure monitoring in the initial evaluation of hypertension in children. Pediatrics 122(6):1177–1181. PubMed

    Article  PubMed  Google Scholar 

  • Tack ED, Perlman JM (1988) Renal failure in sick hypertensive premature infants receiving captopril therapy. J Pediatr 112(5):805–810. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Tallian KB, Nahata MC, Turman MA, Mahan JD, Hayes JR, Mentser MI (1999) Efficacy of amlodipine in pediatric patients with hypertension. Pediatr Nephrol 13(4):304–310. PubMed

    Article  CAS  PubMed  Google Scholar 

  • The GISEN Group (Gruppo Italiano di Studi Epidemiologici in Nefrologia) (1997) Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. Lancet 349(9069):1857–1863

    Article  Google Scholar 

  • Trachtman H, Frank R, Mahan JD, Portman R, Restaino I, Matoo TK, Tou C, Klibaner M (2003) Clinical trial of extended-release felodipine in pediatric essential hypertension. Pediatr Nephrol 18(6):548–553. PubMed

    Article  PubMed  Google Scholar 

  • Trachtman H, Hainer JW, Sugg J, Teng R, Sorof JM, Radcliffe J (2008) Efficacy, safety, and pharmacokinetics of candesartan cilexetil in hypertensive children aged 6 to 17 years. J Clin Hypertens (Greenwich) 10(10):743–750

    Article  CAS  Google Scholar 

  • Trachtman H, Frymoyer A, Lewandowski A, Greenbaum LA, Feig DI, Gipson DS, Warady BA, Goebel JW, Schwartz GJ, Lewis K, Anand R, Patel UD, Best Pharmaceuticals for Children Act-Pediatric Trials Network Administrative Core Committee (2015) Pharmacokinetics, pharmacodynamics, and safety of lisinopril in pediatric kidney transplant patients: implications for starting dose selection. Clin Pharmacol Ther 98(1):25–33. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Truttmann AC, Zehnder-Schlapbach S, Bianchetti MG (1998) A moratorium should be placed on the use of short-acting nifedipine for hypertensive crises. Pediatr Nephrol 12(3):259. PubMed

    CAS  PubMed  Google Scholar 

  • Tullus K (2011) Safety concerns of angiotensin II receptor blockers in preschool children. Arch Dis Child 96(9):881–882. PubMed

    Article  PubMed  Google Scholar 

  • Turner ST, Schwartz GL, Chapman AB, Beitelshees AL, Gums JG, Cooper-DeHoff RM, Boerwinkle E, Johnson JA, Bailey KR (2010) Plasma renin activity predicts blood pressure responses to beta-blocker and thiazide diuretic as monotherapy and add-on therapy for hypertension. Am J Hypertens 23(9):1014–1022. PubMed

    Article  CAS  PubMed  Google Scholar 

  • USFDA (1997) United States Food and Drug Administration Food and Drug Administration Modernization Act of 1997. http://www.fda.gov/regulatoryinformation/legislation/significantamendmentstothefdcact/fdama/fulltextoffdamalaw/default.htm. Accessed 15 Sept 2016

  • USFDA (2002) Best Pharmaceuticals for Children Act. http://www.fda.gov/regulatoryinformation/legislation/significantamendmentstothefdcact/ucm148011.htm. Accessed 15 Sept 2016

  • USFDA (2003a) United States Food and Drug Administration. Summaries of medical and clinical pharmacology reviews. http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM161981.pdf. Accessed 15 Sept 2016

  • USFDA (2003b) Pediatric Research Equity Act of 2003. http://www.fda.gov/downloads/drugs/developmentapprovalprocess/developmentresources/ucm077853.pdf. Accessed 15 Sept 2016

  • USFDA (2004) United States Food and Drug Administration. Summaries of medical and clinical pharmacology reviews. http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM162982.pdf. Accessed 15 Sept 2016

  • USFDA (2016a) United States Food and Drug Administration. New pediatric labeling information database. http://www.accessdata.fda.gov/scripts/sda/sdNavigation.cfm?sd=labelingdatabase. Accessed 15 Sept 2016

  • USFDA (2016b) United States Food and Drug Administration. Drugs to which FDA has granted pediatric exclusivity for pediatric studies under section 505A of the federal food, drug, and cosmetic act. http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM514985.pdf. Accessed 25 Sept 2016

  • USFDA (2016c) United States Food and Drug Administration. Written requests issued. http://www.fda.gov/drugs/developmentapprovalprocess/developmentresources/ucm050002.htm. Accessed 25 Sept 2016

  • USFDA (2017) United States Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/210709Orig1s000OtherR.pdf. Accessed 13 May 2022

  • Valdes Pizarro J, Royo-Bordonada MA (2012) Prevalence of childhood obesity in Spain: National Health Survey 2006–2007. Nutr Hosp 27(1):154–160. PubMed

    CAS  PubMed  Google Scholar 

  • Van Baak MA (1988) Beta-adrenoreceptor blockade and exercise. An update Sports Med 5(4):209–225. PubMed

    Article  PubMed  Google Scholar 

  • Van Baak MA, Koene FMM, Verstappen FTJ (1988) Exercise hemodynamics and maximal exercise capacity furing beta-adrenoreceptor blockade in normotensive and hypertensive subjects. Br J Clin Pharmacol 25(2):169–177. PubMed

    Article  PubMed  PubMed Central  Google Scholar 

  • Vanhees L, Defoor JG, Schepers D, Lijnen P, Peeters BY, Lacante PH, Fagard RH (2000) Effect of bisoprolol and atenolol on endurance exercise capacity in healthy men. J Hypertens 18(1):35–43. PubMed

    Article  CAS  PubMed  Google Scholar 

  • von Vigier RO, Franscini LM, Bianda ND, Pfister R, Casaulta Aebischer C, Bianchetti MG (2001) Antihypertensive efficacy of amlodipine in children with chronic kidney diseases. J Hum Hypertens 15(6):387–391

    Article  CAS  Google Scholar 

  • Wang Y, Lobstein T (2006) Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 1(1):11–25. PubMed

    Article  PubMed  Google Scholar 

  • Webb NJ, Wells TG, Shahinfar S, Massaad R, Dankner WM, Lam C, Santoro EP, McCrary Sisk C, Blaustein RO (2014) A randomized, open-label dose-response study of losartan in hypertensive children. Clin J Am Soc Nephrol 9(8):1441–1448

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Welch WP, Yang W, Taylor-Zapata P, Flynn JT (2012) Antihypertensive drug use by children: are the drugs labeled and indicated? J Clin Hypertens (Greenwich) 14(6):388–395. PubMed

    Article  Google Scholar 

  • Wells T, Frame V, Soffer B, Shaw W, Zhang Z, Herrera P, Shahinfar S (2002) A double-blind, placebo-controlled, dose-response study of the effectiveness and safety of enalapril for children with hypertension. J Clin Pharmacol 42(8):870–880. PubMed

    Article  CAS  PubMed  Google Scholar 

  • Woroniecki RP, Flynn JT (2005) How are hypertensive children evaluated and managed? A survey of North American pediatric nephrologists. Pediatr Nephrol 20(6):791–797

    Article  PubMed  Google Scholar 

  • Wuhl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Moller K, Wigger M, Peruzzi L, Mehls O, Schaefer F (2009) Strict blood-pressure control and progression of renal failure in children. N Engl J Med 361(17):1639–1650

    Article  PubMed  Google Scholar 

  • Yoon EY, Cohn L, Rocchini A, Kershaw D, Freed G, Ascione F, Clark S (2012) Antihypertensive prescribing patterns for adolescents with primary hypertension. Pediatrics 129(1):e1–e8. PubMed

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Division of Nephrology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Michael A. Ferguson & Deborah R. Stein

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  1. Michael A. Ferguson
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Editors and Affiliations

  1. Division of Nephrology, Seattle Children's Hospital, Seattle, WA, USA

    Joseph T. Flynn

  2. Massachusetts General Hospital, Boston, MA, USA

    Julie R. Ingelfinger

  3. Johns Hopkins University, Baltimore, MD, USA

    Tammy Brady

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  1. Department of Pediatrics, Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Tammy M. Brady MD

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Ferguson, M.A., Stein, D.R. (2022). Pharmacologic Treatment of Pediatric Hypertension. In: Flynn, J.T., Ingelfinger, J.R., Brady, T. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-31420-4_36-2

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  1. Latest

    Pharmacologic Treatment of Pediatric Hypertension
    Published:
    28 July 2022

    DOI: https://doi.org/10.1007/978-3-319-31420-4_36-2

  2. Original

    Pharmacologic Treatment of Pediatric Hypertension
    Published:
    08 May 2017

    DOI: https://doi.org/10.1007/978-3-319-31420-4_36-1

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