In children with hypertension, non-pharmacological measures are often recommended as first-line therapy, but a significant proportion of children will eventually require pharmacological treatment to reduce blood pressure, especially those with evidence of end organ damage at presentation or during follow-up.
How are antihypertensive drugs prescribed in children and adolescents?
Antihypertensive drug prescribing in children and adolescents should generally begin with the physician’s choosing an agent appropriate to the underlying etiology of the patient’s hypertension. An example of this is the use of diuretics in acute glomerulonephritis or other forms of volume-overload hypertension.
How is hypertension (high blood pressure) treated in children?
After the diagnosis of hypertension has been confirmed and the underlying etiology (if any) identified, an individualized treatment regimen should be initiated. Most authorities recommend that this include non-pharmacologic measures for all patients, with addition of antihypertensive medications in a selected group of children (Table 3 ).
What are the long-term sequelae of persistent hypertension in children?
There is a paucity of data on the long-term sequelae of persistent hypertension in children, but it is known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood. The prevalence of hypertension in children is rising, most likely due to a concurrent rise in obesity rates.
What is the target blood pressure for children with chronic renal disease?
The NHBPEP Working Group recommended that children with chronic renal disease have a target blood pressure <90th percentile for age, gender, and height and that ACE inhibitors or ARBs should be used preferentially in children with proteinuric renal disease [2].
When do you treat hypertension in children?
Lifestyle changes are recommended for children with hypertension (defined as blood pressure >95th percentile) or those with elevated blood pressure (defined as blood pressure >90th to the 95th percentile or if blood pressure exceeds 120/80 mmHg in adolescents 13 years or older).
How do you manage hypertension in children?
Even if your child takes medication for high blood pressure, lifestyle changes can make the medication work better.Control your child's weight. ... Give your child a healthy diet. ... Decrease salt in your child's diet. ... Encourage physical activity. ... Limit screen time. ... Get the family involved.
How is hypertension treated in teens?
Therapeutic lifestyle modification is essential for any child or adolescent with hypertension and should include regular physical activity, a diet limited in sodium but rich in fresh fruits and vegetables, fiber, and low-fat dairy products, and the avoidance of excess weight gain [2].
What is pediatric hypertension?
High blood pressure (hypertension) in children is blood pressure that is at or above the 95th percentile for children who are the same sex, age and height as your child. There isn't a simple target range for high blood pressure in all children because what's considered normal changes as children grow.
What does a ACE inhibitor do?
Angiotensin-converting enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure. ACE inhibitors prevent an enzyme in the body from producing angiotensin II, a substance that narrows blood vessels.
What is a thiazide diuretic drug?
Thiazide diuretics are an FDA-approved class of drugs that inhibit the reabsorption of 3% to 5% of luminal sodium in the distal convoluted tubule of the nephron. By doing so, thiazide diuretics promote natriuresis and diuresis.
Which is the best medicine for high blood pressure?
In terms of prescriptions written, here are the top 4 high blood pressure medications,the ACE inhibitor lisinopril (Prinivil, Zestril) tops the list,followed by amlodipine besylate (Norvasc),a calcium channel blocker, and.generic hydrochlorothiazide (HCTZ).
What are ACE inhibitors examples?
Angiotensin-converting enzyme inhibitor (ACE inhibitors) drugs include Benazepril (Lotensin), Captopril (Capoten), Enalapril/Enalaprilat (Vasotec oral and injectable), Fosinopril (Monopril), Lisinopril (Zestril and Prinivil), Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril), Ramipril (Altace), and ...
Is hypertension Common in Kids?
About 3.5 percent of U.S. children aged 18 and under have hypertension (high blood pressure), but that number may be even higher. Most children with the condition do not have symptoms. Complications include organ damage.
What is the most common cause of secondary hypertension in children?
Renal disease is the most common cause of secondary hypertension in children. Other causes include endocrine disease (e.g., pheochromocytoma, hyperthyroidism) and pharmaceuticals (e.g., oral contraceptives, sympathomimetics, some over-the-counter preparations, dietary supplements).