title: [Treatment of arterial hypertension in children and adolescents--Update of therapeutic options].
abstract: Changing living conditions, which lead to physical inactivity and obesity, are probably the main reason for the establishment of risk factors for cardiovascular diseases in children and adolescents. In the past those risk factors were typically seen only in the elderly. On long-term, the elevated body-mass-index is a very important risk factor for primary arterial hypertension in children and adolescents, because it is responsible for both structural and functional changes in the cardiovascular system. Regular screening for these target organ damages is necessary. However, the role of newer methods has still to be proven in current research. The primary therapeutical options for this group are life style interventions like body weight control and physical activity. Children and adolescents with arterial hypertension persisting despite life style interventions should receive medication early, in order to prevent persistent target organ damage. Drug therapy should start as mono therapy--depending on patient profile--with one ACE inhibitor, angiotensin II receptor antagonist, calcium channel blocker or beta-blocker. If blood pressure cannot be reduced into the target area by mono therapy, combination therapy with different mechanisms should be started. Forms of secondary arterial hypertension have to be treated according to the primary disease.
authors.forename: Nadine
authors.initials: N
authors.lastname: Gilbert
authors.forename: Alfred
authors.initials: A
authors.lastname: Hage
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D004359:Drug Therapy, Combination; D000075222:Essential Hypertension; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*
chemical_list: D000959:Antihypertensive Agents