Ferguson Michael A, Flynn Joseph T
Division of Nephrology, Boston Children's Hospital, Department of Pediatrics Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA,
Pediatr Nephrol. 2014 Jun;29(6):979-88. doi: 10.1007/s00467-013-2510-z. Epub 2013 May 29.
Hypertension has traditionally been regarded as an uncommon diagnosis in childhood and adolescence; however, there is compelling evidence to suggest that its prevalence is on the rise, particularly in those with obesity. As a result, pediatricians increasingly are asked to evaluate and manage patients with elevated blood pressure. An increased emphasis on conducting drug trials in children over the last 15 years has yielded important advances with respect to evidence-based data regarding the efficacy and safety of antihypertensive medications in children and adolescents. Unfortunately, data to definitively guide selection of initial agents is lacking. This article will present guidelines for the appropriate use of antihypertensive medications in the pediatric population, including the rational approach to selecting an appropriate medication with respect to pathophysiology, putative benefit, and likelihood for side effects.
传统上，高血压在儿童和青少年中被认为是一种不常见的诊断；然而，有令人信服的证据表明其患病率正在上升，尤其是在肥胖人群中。因此，越来越多的儿科医生被要求评估和管理血压升高的患者。在过去15年里，对儿童进行药物试验的重视程度不断提高，在儿童和青少年抗高血压药物疗效和安全性的循证数据方面取得了重要进展。不幸的是，缺乏明确指导初始药物选择的数据。本文将介绍在儿科人群中合理使用抗高血压药物的指南，包括根据病理生理学、假定益处和副作用可能性选择合适药物的合理方法。
