Treatment of systemic hypertension in children and adolescents

Abstract

This review aims to update the practitioner in recent developments in the treatment of hypertension in children and adolescents. In the last years, the treatment of hypertension in children and adolescents has been characterized by an improvement in the definition of hypertension and the more widespread use of the 24-h blood pressure monitor to define the hypertension pattern and assess efficacy of the therapy. A few studies on the use of converting enzyme inhibitors and angiotensin II receptor blocker emphasizing doses, efficacy, and side effects have been published. Of special interest is the tantalizing hypothesis on the role of uric acid in essential hypertension and the practical application of the use of allopurinol as monotherapy for this condition. The authors aim to convey the need to define the blood pressure pattern in these patients before any type of therapy is started and the titration of medications according to the pathophysiologic mechanisms involved.