Pharmacological interventions for hypertension in children

Chaturvedi, Swasti; Lipszyc, Deborah; Licht, Christoph; Craig, Jonathan C.; Parekh, Rulan S.

doi:10.1002/14651858.cd008117.pub2

Cited by 41 publications

(31 citation statements)

References 53 publications

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“…effective antihypertensive drug therapies are available for use in adults and have been evaluated in children. 58 However, recent data demonstrate that diagnosis and treatment rates are markedly lower in young adults with isH compared with those with systolic-diastolic or isolated diastolic hypertension. 59 Moreover, as discussed earlier, hypertension seems to develop early in life and, once established, is irreversible.…”

Section: How To Treat Ish In Young People?mentioning

confidence: 99%

“…Se encuentran disponibles tratamientos con antihipertensivos efectivos para ser utilizados en adultos, y han sido evaluados en niños. 58 Sin embargo, datos recientes demuestran que las tasas de diagnóstico y tratamiento son notablemente más bajas en adultos jóvenes con HSA que en aquellos con hipertensión diastólica-sistólica o diastólica aislada. 59 Además, como se debatió anteriormente, la hipertensión pareciera desarrollarse en las primeras etapa de la vida y una vez establecida, es irreversible.…”

Section: ¿Cómo Tratar La Hsa En Personas Jóvenes?unclassified

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Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated

et al. 2016

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Section: How To Treat Ish In Young People?mentioning

confidence: 99%

Section: ¿Cómo Tratar La Hsa En Personas Jóvenes?unclassified

Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated

et al. 2016

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“…It has been reported that less salt and water decrease the blood volume, thereby making blood arteries and veins flow smoother [4][5][6] . Lisinopril, paradigm of ACE inhibitors acts on the mechanism that narrows blood vessels, so that by blocking it, lisinopril causes blood vessels to relax, allowing more blood to flow in the body [7,8] . However, patients who suffer from hypertension can bring their blood pressure back to normal by recommending the drug.…”

Section: Introductionmentioning

confidence: 99%

Research on garlic capsule and selenium-vitamin A, vitamin B, vitamin C applied in therapy of acute hepatocellular damage in a rat model

Akintunde

Bolarin

2015

Journal of Acute Disease

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A B S T R A C TObjectives: To evaluate the toxicity of lisinopril in liver of male rats and its reversal effect of garlic capsule (GAR) and selenium-vitamin A, vitamin B, vitamin C (SACE). Methods: Thirty five adult male wistar rats were randomly assigned into 5 groups of 7 animals per group. Group I serves as the control, animals in Groups II, III, IV and V received 28 mg/kg body weight of lisinopril via oral route. Group III was co-treated with GAR at therapeutic dose of 250 mg/kg body weight per day. Group IV was co-treated with SACE at dose of 500 mg/kg body weight. Lastly, group V was co-treated with GAR and SACE at doses of 250 and 500 mg/kg body weight respectively, and the experiment last for 8 days.Results: Administration of lisinopril caused systemic toxicity in liver as well as adverse histopathologic changes in the tested tissue. While GAR and SACE significantly (P < 0.05) reversed the toxic effects induced by lisinopril. Conclusions: Collectively, the results suggest that therapeutic dose of lisinopril elicits toxicity in male rats through induction of oxidative damage and depletion of cellular adenosine triphosphate. The reversal effects of GAR and SACE during lisinopril treatment suggest that these antioxidants may find clinical application in cellular damage involving ROS and adenosine triphosphate.

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“…The risks of ‘off-label’ use are generally accepted and recently highlighted by Wharton et al, 30 which demonstrated that a quarter of the drugs that received new paediatric labelling obtained a new paediatric safety signal. Furthermore, the recently published Cochrane review evaluating the efficacy and safety of antihypertensive therapies, including ACE inhibitors, could only include four studies evaluating lisinopril (1), enalapril (2) and fosinopril (1) in the analysis 6 15 17–20. Since trials comparing an ACE inhibitor directly to placebo are lacking, ACE inhibitors were not included in the meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…These incentives resulted in an increased number of published clinical trials in hypertensive children. In 2014, the first comprehensive Cochrane review about pharmacological interventions in hypertensive children was published evaluating randomised controlled trials (RCTs) with antihypertensive therapies, including ACE inhibitors 6. However, only four trials evaluating enalapril, lisinopril and fosinopril were included and the review was not believed to be robust enough to provide firm recommendations for first-line agents in children with hypertension 6…”

Section: Introductionmentioning

confidence: 99%

Therapeutic efficacy and safety of ACE inhibitors in the hypertensive paediatric population: a review

2016

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Paediatric Nephrology (3K12D), Ghent University Hospital Ghent, BELGIUM -Contact: evelien.snauwaert@uzgent.be A literature search was performed in PubMed, including abstracts from 1980 to April 2015. Search terms hypertension, child, paediatric, ACE (inhibitors), RAAS and kallikrein-kinin sytem, and following drugs: captopril, lisinopril, enalapril, ramipril and fosinopril. + "snowball method" Inclusion intervention studies, observational studies and reviews of ACE inhibitors in hypertensive children (0-18 years) Exclusion not published in English, editorial pieces and opinions were excluded. InformationDesign, number of patients, age, ACE inhibitor, dose, formulation, primary end-points and adverse events. MethodsThe recent legislative initiatives increased the availability of paediatric labelling of ACE inhibitors. Nevertheless, many drugs used by hypertensive children have an insufficiently mapped out efficacy and safety profile and lack paediatric labelling. Moreover, many clinical questions remain and consequently complicate the selection of the most appropriate and effective ACE inhibitor in hypertensive children. The legislative initiatives also failed to fulfil several of paediatric needs: absence of long-term safety data on growth and maturation, absence of commercially available child-friendly formulations and incomplete evaluation of the entire paediatric hypertension population. Additional efforts are needed to close the gap between the availability of drugs that are labelled and indicated for paediatric use and the actual drug usage in children, especially in young children, neonates and children with severe hypertension, renal transplantation or severe renal impairment. ConclusionsSince 1997, strong incentives have been introduced worldwide to improve access to safe and effective medicines addressing the therapeutic needs of children.Angiotensin-1 converting enzyme (ACE) inhibitors = Most prescribed antihypertensive drugs in the paediatric population = Prototype drugs targeted by the legislation initiativesEvaluate and describe the current evidence of the efficacy and safety profile of ACE inhibitors in the paediatric populationBackground & purpose

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Pharmacological interventions for hypertension in children

Cited by 41 publications

References 53 publications

Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated

Isolated Systolic Hypertension in Young People Is Not Spurious and Should Be Treated

Research on garlic capsule and selenium-vitamin A, vitamin B, vitamin C applied in therapy of acute hepatocellular damage in a rat model

Therapeutic efficacy and safety of ACE inhibitors in the hypertensive paediatric population: a review

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