Nephrology Division, Department of Pediatrics, University of Florida, Gainesville, Florida 32610-0296, USA.
Curr Opin Pediatr. 2009 Oct;21(5):600-4. doi: 10.1097/MOP.0b013e32832ff3a7.
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.
本综述旨在为临床医生提供儿童和青少年高血压治疗的最新进展。
近年来，儿童和青少年高血压的治疗特点是对高血压的定义有所改善，并且更广泛地使用 24 小时血压监测来定义高血压模式和评估治疗效果。已经发表了一些关于使用血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体阻滞剂的研究，强调了剂量、疗效和副作用。特别有趣的是关于尿酸在原发性高血压中的作用的诱人假说，以及将别嘌醇作为单一疗法用于该病症的实际应用。
作者旨在传达在开始任何类型的治疗之前确定这些患者的血压模式的必要性，并根据所涉及的病理生理机制调整药物剂量。
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