Cardiovascular drugs in children. II. Angiotensin-converting enzyme inhibitors in pediatric patients

Multiple arterial stenoses of unknown aetiology in the coronary, cerebral, and brachial arteries.

“…We used a converting enzyme inhibitor, which is one of the most useful drugs for symptomatic hypertension, whatever the serum renin concentration." 12 Subsequently she did not have hypertension or any side effect for nine years. She safely stopped taking the drug at the age of 11 years when the serum renin concentration was found to be normal.…”

“…(Br HeartJ_ 1993;70:386-390) In 1991 we described a girl with multiple coronary stenoses of unknown aetiology' and we also reported on an adolescent boy with silent coronary ischaemia. 2 We now report another adolescent girl who had both silent myocardial ischaemia with multiple coronary stenoses and multiple lesions in the cerebral 12 yr RCA occlusion vi 17 Figure 1 Electrocardiographic changes, electrocardiogram recorded when the patient was seven months old, showing left ventricular hypertrophy with ST segment depression and inverted T wave in leads I, alVF, and VS. These patterns gradually improved.…”

Treatment of Pediatric Hypertension

“…Captopril generally is given 3 times/day and sometimes twice/day. 1,47 It is cleared renally and thus requires dosage adjustment in patients with renal failure.…”

“…Enalapril has similar efficacy to captopril in controlling blood pressure with once-daily administration. 47 Thus, some of these agents have proved effective in treatment of pediatric hypertension. Furthermore, their adverse effects are not as prominent in children as in adults.…”

“…In addition, taste disturbance, proteinuria, and bone marrow suppression are rare in these patients. [41][42][43][44][45][46][47][48] The most serious adverse effect is significantly reduced renal function in the presence of bilateral renal artery stenosis. Avoidance of ACE inhibitors is advised in these patients.…”