Comparison Of Amlodipine And Enalapril As First Line Agent In Treatment Of Hypertension In Children.

Background: Systemic hypertension is an important condition in childhood, with an estimated global population prevalence of 1-2%. The public health significance of hypertension is based on observations that confirm a strong tracking of blood pressure levels from childhood to adolescence. Commonly used medications as first line in children include Angiotensin Converting Enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCB), and β Blockers. Adult clinical practice guidelines such as Joint National Committe-8 (JNC-8) have clear recommendations based on clinical trial evidence for the first line drug. However, in children there is lack of evidence for clear recommendations for the first line drug Design: Double blinded Randomized control trial Setting: The study was conducted in Indira Gandhi institute of child health, Bangalore from January 2016 to January 2017. Participants :The study comprised of Children aged 3-18 years with hypertension. Objectives : (1) Whether the hypertension was controlled with the drug used (2) Dose required for the control of hypertension (3) Duration needed for the control of hypertension(4) The need to use additional antihypertensive drugs to control hypertension. (5) Adverse drug reactions (ADR) Results: The mean age at presentation was 9.23±0.35 years with males being 57.5 % and females being 42.5%. Renal cause of hypertension was the most common cause with nephrotic syndrome accounting for 46.25% and Acute Glomerulonephritis 42.5 %. Primary hypertension was seen 6.25%. Amlodipine controlled blood pressure in 97.5 % children and Enalapril in 92.5%.. The reduction in blood pressure were comparable at 24, 48 and 72 hours. Mean dose required for control of blood pressure in Amlodipine group was 0.26±0.01mg/kg/day and Enalapril group was 0.25±0.01mg/kg/day. No adverse reactions was noted to either drug. Conclusion: 1) Amlodipine and Enalapril are both efficacious in the control of Paediatric Hypertension and there is no statistically significant difference between the two groups in terms of Blood Pressure control.2) Administration of Enalapril and Amlodipine was not associated with any adverse effects. [ABSTRACT FROM AUTHOR]