Effects of antihypertensive drugs on blood pressure and proteinuria in childhood.
BACKGROUND
Historically, there have been few drug trials for antihypertensive treatment in childhood and recommendations have been extrapolated from data obtained in adulthood. During the last decade an increased awareness of the risks of childhood hypertension stimulated clinical trials of antihypertensive agents in children.


OBJECTIVE
The aim of this article is to systematically review the studies published between 1995 and 2006 that deal with the effect of antihypertensive drugs on childhood hypertension or proteinuria.


METHODS
Medline, Current Contents, personal files and reference lists were used as data sources.


RESULTS
Fifty-two out of 79 initially found reports were excluded. Consequently 27 articles were retained for the final analysis. The blood pressure reduction was similar with angiotensin-converting enzyme inhibitors (10.7/8.1 mmHg), angiotensin II receptor antagonists (10.5/6.9 mmHg) and calcium-channel blockers (9.3/7.2 mmHg). In addition angiotensin-converting enzyme inhibitors (by 49%) and angiotensin II receptor antagonists (by 59%) significantly reduced pathological proteinuria.


CONCLUSIONS
The blood pressure reduction of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and calcium-channel blockers is almost identical. In children with pathological proteinuria angiotensin-converting enzyme inhibitors or angiotensin II antagonists are superior to calcium-channel blockers.
Simonetti
Giacomo D
GD
Department of Pediatrics, Division of Pediatric Nephrology, University of Berne Inselspital, Switzerland. giacomo.simonetti@insel.ch
Rizzi
Mattia
M
Donadini
Rebecca
R
Bianchetti
Mario G
MG
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D002986:Clinical Trials as Topic; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D011507:Proteinuria / Q000188:drug therapy*
D000959:Antihypertensive Agents