Main Article Content

Abstract

Background


An increasing number of healthy children and  adolescents  across  the  world  are being   diagnosed   with   hypertension, which  is  an  emerging  problem  that  no pediatrician can afford to ignore. Hypertension in children is defined as systolic BP (SBP) and/or diastolic BP (DBP) ≥95th percentile for sex, age, and height on ≥3 occasions. It occurs in 1%–10% of children and adolescents and, at younger ages, frequently has a cardiac or renal cause. Losartan, an Angiotensin II Receptor Blocker (ARB), is an antihypertensive therapy with demonstrated benefit in children.


Objectives


Once-daily Losartan reduces Blood Pressure in a dose-dependent manner and is well tolerated in hypertensive children aged 6–16 years. This study assessed the dose-response relationship, safety, and tolerability of Losartan in hypertensive children aged 61 year to 5 years.


Design


This was a 10-week, randomized, open-label, dose-ranging study.


Duration


One year (November 2016 - December 2017)


Setting


Gandhi Medical College, Hyderabad.


Participants


Sixty patients diagnosed at Gandhi Medical College, Hyderabad.


Methods


Patients were randomized to Losartan at the following dosages: 0.1 mg/kg per day (low), 0.3 mg/kg per day (medium), or 0.7 mg/kg per day (high). Losartan was titrated to the next dose level (to a 1.4 mg/kg per day maximum dosage, not exceeding 100 mg/d, which was not one of the three original doses offered at randomization) at weeks 3, 6, and 9 for patients who did not attain their goal BP and were not taking the highest dose. Dose response was evaluated by analyzing the slope of change in sitting systolic BP (SBP; primary end point) and diastolic BP (DBP; secondary end point) after 3 weeks compared with baseline. Adverse events (AEs) were recorded throughout.


Results


Mean sitting BP decreased from baseline in the low, medium, and high-dose groups by 7.2, 7.4, and 6.8 mmHg, respectively, for SBP and 8.0, 5.2, and 6.7 mmHg, respectively, for DBP after 3 weeks. No dose-response relationship was established by the slope analysis on SBP (P=0.74) or DBP (P=0.63). The BP-lowering effect was observed throughout the one year extension.


Conclusions


Hypertensive children aged 1 year to 6 years treated with Losartan 0.1–0.7 mg/kg per day had clinically significant decreases from baseline in SBP and DBP, yet no dose-response relationship was evident. Losartan, at a dosage up to 1.5 mg/kg per day, was well tolerated.

Keywords

Hypertension Children Management ARB Losartan

Article Details

How to Cite
Dr. S. Umamaheswara Raju, Dr. J. Margaret Viola, & Dr P. Raghunadha Rao. (2021). Losartan in management of hypertension in children. International Journal of Research in Pharmacology & Pharmacotherapeutics, 7(4), 313-319. Retrieved from https://ijrpp.com/ijrpp/article/view/302

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