Chronic Hypertension

Management

Drugs used in chronic hypertension

Primary/Essential hypertension: Occurs most commonly in adolescents. The patient is often asymptomatic and well. It is diagnosed by excluding underlying causes of hypertension. 

Chronic secondary hypertension: All children with incurable forms of persistent secondary hypertension require medicine treatment over and above general and supportive measures. 

Management 

Refer all children with chronic hypertension for specific diagnosis, planning of treatment and long-term follow-up to tertiary centre. 

Drugs used in chronic hypertension 

A. ACE-Inhibitor: Captopril and Enalapril (absolutely contraindicated in acute hypertension) 

Α- Blocker: Prazosin (phaeochromocytoma-associated hypertension) 

B. β-Blocker: Propranalol (short acting), Atenolol (longer acting), Labetalol (mixed alpha/beta) 

C. Ca++ Channel Blocker: Amlodipine (long acting) and Nifedipine (short acting) 

D.Diuretic: Lasix, spironolactone and Hydrochlorothiazide 

E.Everything else: Hydralazine/Minoxidil (Direct arteriolar dilatation), Clonidine/Methyldopa (Central)