Key result
ACE inhibitors decreased systolic and/or diastolic blood pressure with an overall favourable short-term safety profile in hypertensive children, based on a review of 16 studies.
Why the study?
Do ACE inhibitors decrease blood pressure safely in the hypertensive paediatric population?
Do ACE inhibitors decrease blood pressure safely in the hypertensive paediatric population?
ACE inhibitors are effective and safe for short-term blood pressure reduction in hypertensive children, but long-term safety data and child-friendly formulations remain unmet needs.
May support short-term use in hypertensive children; leaves open long-term safety and formulations.
PURPOSE: Since 1997, strong incentives have been introduced worldwide to improve access to safe and effective medicines addressing the therapeutic needs of children. ACE inhibitors, the most prescribed antihypertensive drugs in the paediatric population, are one of the prototype drugs targeted by the legislation initiatives. Our purpose in assembling this review is to evaluate and describe the current evidence for the efficacy and safety profile of ACE inhibitors in the paediatric population. METHODS: The authors made a descriptive review of the literature from 1980 to 2015 using the following search terms: hypertension, child, paediatric, ACE (inhibitors), renin-angiotensin aldosterone system, captopril, lisinopril, enalapril, ramipril and fosinopril. RESULTS: A total of 16 studies evaluating efficacy and safety of ACE inhibitors were included in this review. The included studies demonstrate that ACE inhibitors have the potency to decrease the systolic and/or diastolic blood pressure with an overall favourable safety profile in a short-term period. More importantly, the incentives resulted in an improvement of the overall availability of paediatric labelling, dosing and safety information for ACE inhibitors. However, they failed to fulfil several of paediatric needs: absence of long-term safety data on growth and maturation, absence of commercially available child-friendly formulations and incomplete evaluation of the entire paediatric hypertension population. CONCLUSION: Additional efforts are needed to close the gap between the availability of drugs that are labelled and indicated for paediatric use and the actual drug usage in children, especially in young children, neonates and children with severe hypertension, renal transplantation or severe renal impairment.
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Snauwaert et al. (2016) conducted a review in Hypertension. ACE inhibitors was evaluated on Systolic and/or diastolic blood pressure and safety profile. ACE inhibitors decreased systolic and/or diastolic blood pressure with an overall favourable short-term safety profile in hypertensive children, based on a review of 16 studies.
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