Tocci Giuliano, Volpe Massimo
Department of Clinical and Molecular Medicine, Faculty of Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.
Vasc Health Risk Manag. 2011;7:177-81. doi: 10.2147/VHRM.S11672. Epub 2011 Mar 31.
Prevalence of hypertension in children and adolescents has progressively and continuously increased over recent decades. Thus, early and effective control of high blood pressure may be considered an effective therapeutic approach, in order to reduce the burden of hypertension-related cardiovascular disease in future. In the past, due to the absence of prospective, long-term, randomized, controlled clinical trials performed in young hypertensive patients, lifestyle changes have been long seen as the only strategy to reduce high blood pressure levels. More recently, clinical data on the efficacy and safety of five major classes of antihypertensive drugs (including angiotensin converting enzyme inhibitors, angiotensin receptor blockers [ARBs], beta-blockers, calcium-antagonists, and diuretics) have become available. In particular, these trials demonstrated dose-dependent blood pressure reductions and a good tolerability profile of several ARBs in hypertensive children and adolescents. An overview is provided of the clinical benefits of early detection and prompt intervention of high blood pressure levels, with a closer analysis of recent clinical trials, performed with olmesartan medoxomil in young subjects with hypertension.
近几十年来，儿童和青少年高血压的患病率一直在逐步持续上升。因此，早期有效控制高血压可被视为一种有效的治疗方法，以减轻未来高血压相关心血管疾病的负担。过去，由于缺乏针对年轻高血压患者进行的前瞻性、长期、随机对照临床试验，长期以来生活方式改变一直被视为降低血压水平的唯一策略。最近，已有关于五大类抗高血压药物（包括血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂 [ARB]、β受体阻滞剂、钙拮抗剂和利尿剂）疗效和安全性的临床数据。特别是，这些试验证明了几种ARB在高血压儿童和青少年中可使血压呈剂量依赖性降低，且耐受性良好。本文概述了早期发现和及时干预高血压水平的临床益处，并对奥美沙坦酯在年轻高血压患者中进行的近期临床试验进行了更深入的分析。
