Antihypertensives now also being tested on
and authorized
for the treatment of children
and adolescents
Berlin, May 2008 - Hypertension is by no means restricted to adults.
Children and adolescents may also suffer from high blood pressure
that requires treatment. Until recently doctors have only been able
to use antihypertensives off-label for the treatment of their young
patients. In Oder to improve the medicinal treatment of children and
adolescents, the new EU Regulation on medicinal products for
paediatric use (1901/2006/EC) calls for studies on this population
group. At the International Hypertension Congress in Berlin in June
Experts in the field will be discussing which drugs are also suitable
for use on children and adolescents.
"Until recently, almost all hypertension drugs were on the EMEA list of
drugs whose use in the treatment of children and adolescents required
further testing", comments Professor Dr. Dr. h.c. Wolfgang Rascher of
the Department for Children and Adolescents at Erlangen's University
Hospital. However there have always been children who needed treatment
for high blood pressure. In small children it is usually caused by
congenital blood vessel malformation or kidney disease. In adolescents,
like in adults, it is increasingly the result of adiposity and lack of exercise.
"But in pharmacotherapy children must not be treated like "small adults".
Above all, even more than other doctors, paediatricians must give
consideration to the long-term effects of the drugs they prescribe," warns
Rascher. This is why in the past children have usually been treated with
beta-blocker antihypertensives. These act by lowering the heart rate and
reducing the strength of contractions. They also have the advantage of
being easy to dose. "Nevertheless, prescription frequency has dwindled
somewhat over recent years because some beta-blockers have
undesirable effects on the metabolism, with one result being weight
increase, for example," explains Rascher. "For young hypertension
patients who tend to be overweight anyway, this is clearly not
recommendable."
Over recent years paediatricians have therefore tended to favor another
type of drug, namely ACE inhibitors. "These drugs are more expensive,
but act selectively on the body's natural blood pressure regulation
system," explains Rascher. Angiotensin antagonists, also known as
sartanes, work in much the same way. They are currently being tested
extensively on young hypertension sufferers. "This is a very positive
development because it enables us to improve the treatment of children
and adolescents. It would be advantageous if we could soon have similar
studies for the older diuretics as well," says Rascher. For, as with adults,
one single drug is not always enough. Doctors sometimes have to
prescribe a combination of several different drugs when treating children
and adolescents, too. "The more choice there is," says Rascher, "the
more likely we are to find a suitable drug."
PLEASE NOTE: Official Press Conferences (during the Congress)
