Most Read Articles
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
22 Aug 2018
In patients with atrial fibrillation (AF) naïve to oral anticoagulants (OACs), standard-dose nonvitamin K antagonist OACs (NOACs) provides better survival benefits than warfarin, a recent meta-analysis has shown.
Stephen Padilla, 31 Aug 2018
Treatment with rivaroxaban results in less recurrent venous thromboembolism (VTE) in frail patients with VTE, with similar good bleeding outcomes, compared with warfarin, reports a study.
Stephen Padilla, 11 Sep 2018
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.

High-dose valsartan reduces systolic BP in children with hypertension

Elaine Soliven
23 Sep 2019

Treatment with a higher rather than a lower dose of valsartan led to significantly greater reductions in systolic blood pressure (BP) in children with hypertension, regardless of their chronic kidney disease (CKD) status, according to a study presented at ESC 2019.

This study involved 127 children (mean age 3.26 years, 63.0 percent boys) with hypertension (defined as mean systolic BP of ≥95th percentile) who were randomized to receive valsartan at either 0.25 or 4 mg/kg per day for a 6-week double-blind period (phase I), followed by valsartan 1 mg/kg per day with an optional titration of 2–4 mg/kg per day for a 20-week open-label period (phase II). The primary endpoint was to evaluate the dose-dependent reduction in mean systolic BP from baseline to 6 weeks. [ESC 2019, abstract P4555]

A total of 120 patients completed phase I, while 114 patients completed phase II, of whom 55 had CKD (mean age, 2.86 years) and 59 did not (mean age, 3.66 years).

At 6 weeks, those who received valsartan 4 mg/kg had a significantly greater reduction in mean systolic BP from baseline than those on 0.25 mg/kg (8.5 vs 4.1 mm Hg; p=0.0157).

This significantly greater reduction in systolic BP applied to patients with CKD who received valsartan 4 mg/kg compared with 0.25 mg/kg (9.2 vs 1.2 mm Hg; p=0.0096).

A greater, but not significant, reduction in mean systolic BP at 6 weeks was also observed among patients without CKD who received valsartan 4 vs 0.25 mg/kg (7.8 vs 6.9 mm Hg; p=0.6531).

A clinically and statistically significant decrease in mean diastolic BP was also observed among patients treated with 4 vs 0.25 mg/kg valsartan (6.8 vs 0.3 mm Hg; p<0.0001), among those with CKD (6.5 vs 4.0 mm Hg; p=0.0030) and without CKD (7.2 vs 1.9 mm Hg; p=0.0042).

Overall, both mean systolic and diastolic BP decreased were sustained at 6–26 weeks in all patients, irrespective of their CKD status.

Adverse events (AEs) occurred at a lower rate in the valsartan 4 vs 0.25 mg/kg arm (41.9 percent vs 51.6 percent). Serious AEs occurred in 3.2 percent of patients at a comparable rate between the two treatment groups.

Respiratory tract infection (5.6 percent), cough or diarrhoea (4.8 percent), and bronchitis (4.0 percent) were the most common AEs reported in both treatment arms.

“[High-dose] valsartan produced clinically relevant reductions in BP with a statistically significant dose-response in children aged 1–5 years with hypertension, with or without CKD. Long-term efficacy was maintained and was generally well-tolerated,” the researchers concluded.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacist - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 25 Jul 2019
Nonvitamin K antagonist oral anticoagulants (NOACs) appear to confer more clinical benefits to elderly patients with atrial fibrillation (AF) than vitamin K antagonist anticoagulants (VKAs), suggests a study, adding that this is primarily driven by the lower rates of major bleeding.
22 Aug 2018
In patients with atrial fibrillation (AF) naïve to oral anticoagulants (OACs), standard-dose nonvitamin K antagonist OACs (NOACs) provides better survival benefits than warfarin, a recent meta-analysis has shown.
Stephen Padilla, 31 Aug 2018
Treatment with rivaroxaban results in less recurrent venous thromboembolism (VTE) in frail patients with VTE, with similar good bleeding outcomes, compared with warfarin, reports a study.
Stephen Padilla, 11 Sep 2018
Use of diclofenac, a traditional nonsteroidal anti-inflammatory drug (NSAID) with cyclo-oxygenase-2 (COX-2) selectivity similar to COX-2 inhibitors, is associated with higher cardiovascular health risk compared with nonuse, paracetamol use and use of other traditional NSAIDs, a recent study has shown.