Journal article
Pharmacologic Management of Pediatric Hypertension
Paediatric drugs, Vol.18(1), pp.31-43
02/2016
DOI: 10.1007/s40272-015-0151-3
PMID: 26597490
Abstract
Hypertension in children is common, and the prevalence of primary hypertension is increasing with the obesity epidemic and changing dietary choices. Careful measurement of blood pressure is important to correctly diagnose hypertension, as many factors can lead to inaccurate blood pressure measurement. Hypertension is diagnosed based on comparison of age-, sex-, and height-based norms with the average systolic and diastolic blood pressures on three separate occasions. In the absence of hypertensive target organ damage (TOD), stage I hypertension is managed first by diet and exercise, with the addition of drug therapy if this fails. First-line treatment of stage I hypertension with TOD and stage II hypertension includes both lifestyle changes and medications. First-line agents include angiotensin-converting enzyme (ACE) inhibitors, thiazide diuretics, and calcium-channel blockers. Hypertensive emergency with end-organ effects requires immediate modest blood pressure reduction to alleviate symptoms. This is usually accomplished with IV medications. Long-term reduction in blood pressure to normal levels is accomplished gradually. Specific medication choice for outpatient hypertension management is determined by the underlying cause of hypertension and the comparative adverse effect profiles, along with practical considerations such as cost and frequency of administration. Antihypertensive medication is initiated at a starting dose and can be gradually increased to effect. If ineffective at the recommended maximum dose, an additional medication with a complementary mechanism of action can be added.
Details
- Title: Subtitle
- Pharmacologic Management of Pediatric Hypertension
- Creators
- Jason Misurac - Department of Pediatrics, Section of Pediatric Nephrology, Indiana University School of Medicine, 699 Riley Hospital Dr., Room 230, Indianapolis, IN, 46202, USA. jason.misurac@gmail.comKristen R Nichols - Department of Pharmacy, Riley Hospital for Children, Indiana University Health, Indianapolis, IN, USAAmy C Wilson - Department of Pediatrics, Section of Pediatric Nephrology, Indiana University School of Medicine, 699 Riley Hospital Dr., Room 230, Indianapolis, IN, 46202, USA
- Resource Type
- Journal article
- Publication Details
- Paediatric drugs, Vol.18(1), pp.31-43
- DOI
- 10.1007/s40272-015-0151-3
- PMID
- 26597490
- ISSN
- 1174-5878
- eISSN
- 1179-2019
- Language
- English
- Date published
- 02/2016
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984093229102771
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