Simonetti Giacomo D, Rizzi Mattia, Donadini Rebecca, Bianchetti Mario G
Department of Pediatrics, Division of Pediatric Nephrology, University of Berne Inselspital, Switzerland.
J Hypertens. 2007 Dec;25(12):2370-6. doi: 10.1097/HJH.0b013e3282efeb7e.
Historically, there have been few drug trials for antihypertensive treatment in childhood and recommendations have been extrapolated from data obtained in adulthood. During the last decade an increased awareness of the risks of childhood hypertension stimulated clinical trials of antihypertensive agents in children.
The aim of this article is to systematically review the studies published between 1995 and 2006 that deal with the effect of antihypertensive drugs on childhood hypertension or proteinuria.
Medline, Current Contents, personal files and reference lists were used as data sources.
Fifty-two out of 79 initially found reports were excluded. Consequently 27 articles were retained for the final analysis. The blood pressure reduction was similar with angiotensin-converting enzyme inhibitors (10.7/8.1 mmHg), angiotensin II receptor antagonists (10.5/6.9 mmHg) and calcium-channel blockers (9.3/7.2 mmHg). In addition angiotensin-converting enzyme inhibitors (by 49%) and angiotensin II receptor antagonists (by 59%) significantly reduced pathological proteinuria.
The blood pressure reduction of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and calcium-channel blockers is almost identical. In children with pathological proteinuria angiotensin-converting enzyme inhibitors or angiotensin II antagonists are superior to calcium-channel blockers.
从历史上看，儿童高血压的抗高血压治疗药物试验很少，相关建议一直是根据成人数据推断而来。在过去十年中，人们对儿童高血压风险的认识有所提高，这促使了针对儿童抗高血压药物的临床试验。
本文旨在系统回顾1995年至2006年间发表的有关抗高血压药物对儿童高血压或蛋白尿影响的研究。
使用医学文献数据库（Medline）、《现刊目次》、个人文档和参考文献列表作为数据来源。
最初找到的79篇报告中有52篇被排除。因此，最终保留了27篇文章进行分析。血管紧张素转换酶抑制剂（降压10.7/8.1 mmHg）、血管紧张素II受体拮抗剂（降压10.5/6.9 mmHg）和钙通道阻滞剂（降压9.3/7.2 mmHg）的降压效果相似。此外，血管紧张素转换酶抑制剂（降低49%）和血管紧张素II受体拮抗剂（降低59%）能显著减少病理性蛋白尿。
血管紧张素转换酶抑制剂、血管紧张素II受体拮抗剂和钙通道阻滞剂的降压效果几乎相同。对于患有病理性蛋白尿的儿童，血管紧张素转换酶抑制剂或血管紧张素II拮抗剂优于钙通道阻滞剂。
