Baracco Rossana, Kapur Gaurav
Children's Hospital of Michigan/Wayne State University, Detroit, MI, USA.
Patient Prefer Adherence. 2011 Mar 17;5:149-55. doi: 10.2147/PPA.S12166.
Valsartan is a potent antagonist of the type 1 angiotensin receptor (AT(1)). By blocking the actions of angiotensin II on the AT(1), it inhibits vasoconstriction and synthesis of aldosterone thus lowering systemic blood pressure. Valsartan has been approved by the FDA for the treatment of hypertension in children aged 6 years and older. Valsartan can be dosed once a day with a sustained 24-hour effect on blood pressure reduction. The starting dose recommended in children is 1.3 mg/kg once daily (maximum 40 mg) which needs adjustment according to blood pressure response (dose range 1.3-2.7 mg/kg daily; up to 160 mg). A suspension form (4 mg/mL) is available for children who cannot swallow tablets. In patients aged 6 to 16 years, valsartan treatment (from a low dose of 10-20 mg to a high dose of 80-160 mg) resulted in dose-dependent reductions of 7.9-11.5 mmHg in systolic blood pressure and 4.6-7.4 mmHg in diastolic blood pressure. In 1- to 5-year-olds, valsartan (from a low dose of 5-10 mg to a high dose of 40-80 mg) reduced the systolic blood pressure by 8.4-8.6 mmHg and the diastolic blood pressure by 5.5 mmHg. Similar to adults and other antihypertensive medications, the most frequent side effect in children subsequent to valsartan use is headache. Current studies have not shown adverse effects on linear growth, weight gain, head growth, or development in children aged 1 to 5 years subsequent to valsartan use. Based on limited pediatric data, valsartan appears to be well tolerated and efficacious in reducing elevated blood pressure.
缬沙坦是一种强效的1型血管紧张素受体（AT(1)）拮抗剂。通过阻断血管紧张素II对AT(1)的作用，它抑制血管收缩和醛固酮的合成，从而降低全身血压。缬沙坦已获美国食品药品监督管理局（FDA）批准，用于治疗6岁及以上儿童的高血压。缬沙坦可以每天给药一次，对血压降低有持续24小时的效果。儿童推荐的起始剂量为每日1.3毫克/千克（最大剂量40毫克），需要根据血压反应进行调整（剂量范围为每日1.3 - 2.7毫克/千克；最大剂量160毫克）。对于无法吞咽片剂的儿童，有悬浮液剂型（4毫克/毫升）可供使用。在6至16岁的患者中，缬沙坦治疗（从低剂量10 - 20毫克到高剂量80 - 160毫克）导致收缩压剂量依赖性降低7.9 - 11.5毫米汞柱，舒张压降低4.6 - 7.4毫米汞柱。在1至5岁的儿童中，缬沙坦（从低剂量5 - 10毫克到高剂量40 - 80毫克）使收缩压降低8.4 - 8.6毫米汞柱，舒张压降低5.5毫米汞柱。与成人和其他抗高血压药物类似，儿童使用缬沙坦后最常见的副作用是头痛。目前的研究尚未显示缬沙坦使用后对1至5岁儿童的线性生长、体重增加、头部生长或发育有不良影响。基于有限的儿科数据，缬沙坦在降低血压升高方面似乎耐受性良好且有效。
