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(Hypertension. 2008;52:201.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Antihypertensive Therapy in Children

Implications for Future Studies

Alan R. Sinaiko

From the Department of Pediatrics, Medical School, Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.

Correspondence to Alan R. Sinaiko, University of Minnesota Medical School, Department of Pediatrics, 420 Delaware St SE, MMC 491, Minneapolis, MN 55455. E-mail sinai001@umn.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

This issue of Hypertension includes the results from a double-blind, randomized, placebo-controlled antihypertensive drug trial with valsartan in children.¹ It takes the study of hypertension in children another step forward by extending controlled drug trials into the preschool age group (3 to 6 years old).

Historically, blood pressure and hypertension as independent disciplines within pediatrics date only to the 1977 publication of the first report of the Task Force on Blood Pressure in Children. The task force report provided standards for normal and elevated blood pressure in children, based on national population studies, and arbitrarily defined hypertension as blood pressure greater than the 95th percentile of the distribution according to age and sex. As a result of that report and 3 subsequent revisions, measurement of blood pressure and recognition of hypertension as a childhood health care issue have become integral to the practice of pediatrics.

Associated with the rising interest in hypertension was the realization that little was known about the use of antihypertensive drugs in children. The primary concern among pediatricians was related to potential adverse effects, in particular, developmental effects, of using adult drug doses and dosing schedules. At that time there was little incentive for the pharmaceutical companies to test drugs in children, and studies were investigator initiated by a telephone call to the company medical director, with the expense in the low 6 figures. Despite including crossover designs comparing 2 or 3 drugs, washout periods, and dose-response data, those protocols probably would not be funded today . . . [Full Text of this Article]

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Efficacy and Safety of the Angiotensin Receptor Blocker Valsartan in Children With Hypertension Aged 1 to 5 Years

Joseph T. Flynn, Kevin E.C. Meyers, Jose Pacheco Neto, Rejane de Paula Meneses, Aleksandra Zurowska, Arvind Bagga, Lionel Mattheyse, Victor Shi, Jitendra Gupte, Susan Solar-Yohay, Guangyang Han for the Pediatric Valsartan Study Group
Hypertension 2008 52: 222-228. [Abstract] [Full Text] [PDF]