Does my child require medications to control blood pressure? Why and for how long?

Dr. Paula Goel, Pediatrician & Adolescent Specialist

Children with mild (stage I) hypertension, particularly those with essential hypertension, are first managed by lifestyle measures, described above. If blood pressure is not controlled despite these measures, medications are necessary. Occasionally, patients may present with very severe hypertension with complications, including convulsions or breathing difficulty, and require admission for urgent control of blood pressure.

Patients with severe (stage II) hypertension and adverse effects on the heart, kidneys, or eyes require therapy with antihypertensive medications. Most patients with secondary hypertension also require antihypertensive medications. Several medications are approved for the management of hypertension in children and are effective and safe. When prescribing treatment, your physician will also advise regarding the precautions and possible side effects of these medications. Therapy with these agents may require to be reduced or withheld during illnesses when oral intake is limited (e.g., diarrhea, vomiting, and fever).

Lifestyle interventions should be continued in children who are receiving  anti­ hypertensive agents. These measures might help to reduce the dose of medications used. In most cases, these medications need to be taken for several months or years, unless the cause of high blood pressure is temporary, such as acute conditions affecting the kidney ( acute glomerulonephritis).

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