pediatrics
Drugs for Hypertension in Children
Thiazide Diuretics
In addition to other antihypertensive effects, thiazide diuretics (see table Oral Thiazide Diuretics for Hypertension in Children ) cause a small amount of vasodilation as long as intravascular volume is normal. All thiazides are equally effective in equivalent doses. Thiazide diuretics cause potassium loss, so serum potassium should be followed until the level stabilizes. Unless serum potassium is normalized, potassium channels in the arterial walls close and the resulting vasoconstriction makes achieving the blood pressure goal difficult. Patients with potassium levels < 3.5 mEq/L (< 3.5 mmol/L) are given potassium supplements or are instructed about dietary changes that can increase potassium intake. Hypokalemia is less of a problem in hypertensive children, in whom thiazides are usually combined with an angiotensin-converting enzyme (ACE) inhibitor or an In most patients with diabetes, thiazide-type diuretics do not affect control of diabetes. Uncommonly, diuretics precipitate or worsen type 2 diabetes in patients with metabolic syndrome. 