children s health issues
Drug Treatment of High Blood Pressure in Children
Introduction
High blood pressure (hypertension) is persistently high pressure in the arteries. Some children who have high blood pressure need drugs to lower it. (See also High Blood Pressure in Children .) In children under 13 years of age, the values that are considered high vary based on sex, age, and height. Thus, there is no clear-cut blood pressure that indicates high blood pressure for all children. Rather, if blood pressure is the same as or higher than 90% of the blood pressure of children who are the same sex, age, and height, elevated blood pressure is diagnosed. In adolescents (13 years of age or over), blood pressure is classified as it is in adults: Normal: Lower than 120 systolic blood pressure and lower than 80 diastolic blood pressure Elevated: 120 to 129 systolic blood pressure and lower than 80 diastolic blood pressure Stage 1 (mild) high blood pressure: 130/80 to 139/89) Stage 2 high blood pressure: 140/90 or higher (plus Treatment ) is typically started if any of the following apply: High blood pressure, regardless of severity, causes symptoms. Stage 1 hypertension causes organ dysfunction or damage. Stage 2 hypertension is present. Children have chronic kidney disease, diabetes, or heart disease regardless of the stage of high blood pressure. Children who have milder forms of high blood pressure that are not controlled after about 6 months of lifestyle changes will need drug treatment. Drugs that are used in the treatment of high blood pressure are called antihypertensive drugs. Treatment is most effective when the parents, child, and doctor communicate well and discuss the drug treatment program, including possible side effects. Any antihypertensive drug can have side effects, so parents should be alert for them. If side effects develop, parents or the child should tell the doctor, who can adjust the dose or substitute another drug. Doctors typically start antihypertensive drugs, given by mouth, at a low dose and increase the dose as needed to lower blood pressure until the maximum dose of the drug is reached or side effects occur. If blood pressure is still too high, doctors may give children a second drug or switch drugs. There are many types of antihypertensive drugs. Categories include Adrenergic blockers None Angiotensin-converting enzyme (ACE) inhibitors None Angiotensin II receptor blockers (ARBs) None Calcium channel blockers None Thiazide diuretics None Vasodilators None The different types of antihypertensive drugs work in different ways, so there are many options for treatment. It is not unusual for someone who has high blood pressure to be prescribed more than one of the drugs. 