title: Efficacy and safety of the Angiotensin receptor blocker valsartan in children with hypertension aged 1 to 5 years.
abstract: The efficacy and safety of valsartan were studied in 90 children (mean age: 3.2 years; 60% male; 30% black) with systolic blood pressure (SBP) > or =95th percentile. Nineteen percent received valsartan in addition to previous antihypertensive therapy. Subjects were randomly assigned to low-, medium-, or high-dose valsartan for 2 weeks (phase 1) and then reassigned randomly to placebo or to remain on the same valsartan dose for 2 additional weeks (phase 2). After this, subjects were enrolled into a 52-week, open-label phase during which valsartan was dosed to achieve SBP <95th percentile. Statistically significant reductions in SBP and diastolic blood pressure of approximately 8.5 mm Hg and 5.7 mm Hg, respectively, were observed at the end of phase 1 in all of the valsartan dose groups. SBP and diastolic blood pressure were also significantly lower during phase 2 in valsartan recipients compared with placebo recipients. SBP <95th percentile was achieved in 77.3% of subjects during the open-label phase. Adverse events were minor and occurred at similar frequencies in each of the 3 dose groups in phase 1 and at equal frequencies in the valsartan and placebo arms in phase 2. Serious adverse events and drug-related adverse events occurred infrequently during both the double-blind (2.2% and 5.6%, respectively) and open-label (14.8% and 6.8%, respectively) portions of the study. Valsartan treatment had no demonstrable negative effects on growth and development. In this study, the first trial of an antihypertensive agent conducted in children <6 years of age, valsartan effectively lowered SBP and diastolic blood pressure compared with placebo.
authors.affiliation: Division of Nephrology, A-7931, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA. joseph.flynn@seattlechildrens.org
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Flynn
authors.forename: Kevin E C
authors.initials: KE
authors.lastname: Meyers
authors.forename: Jose Pacheco
authors.initials: JP
authors.lastname: Neto
authors.forename: Rejane
authors.initials: R
authors.lastname: de Paula Meneses
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zurowska
authors.forename: Arvind
authors.initials: A
authors.lastname: Bagga
authors.forename: Lionel
authors.initials: L
authors.lastname: Mattheyse
authors.forename: Victor
authors.initials: V
authors.lastname: Shi
authors.forename: Jitendra
authors.initials: J
authors.lastname: Gupte
authors.forename: Susan
authors.initials: S
authors.lastname: Solar-Yohay
authors.forename: Guangyang
authors.initials: G
authors.lastname: Han
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D007223:Infant; D008297:Male; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine