From the Guidelines
Blood pressure medications can be prescribed to 15-year-olds with hypertension, but only under careful medical supervision, with ACE inhibitors, such as lisinopril, being a commonly recommended option 1. When considering antihypertensive medications for a 15-year-old adolescent, it's crucial to prioritize their safety and efficacy. According to the expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents, several classes of medications are available for pediatric use, including:
- ACE inhibitors, such as lisinopril, with an initial dose of 0.07 mg/kg per day up to 5 mg/day and a maximal dose of 0.6 mg/kg per day up to 40 mg/day 1
- Angiotensin receptor blockers (ARBs), like losartan, with an initial dose of 0.7 mg/kg per day up to 50 mg/day and a maximal dose of 1.4 mg/kg per day up to 100 mg/day 1
- Calcium channel blockers, such as amlodipine, with an initial dose of 2.5 mg/day and a maximal dose of 5 mg/day 1 The choice of medication depends on the individual's overall health, the severity of hypertension, and any coexisting conditions. It's essential to start with a lower dose and gradually adjust it based on the patient's response. Regular monitoring by a healthcare provider is necessary to assess the medication's effectiveness and watch for potential side effects. Key considerations in managing adolescent hypertension include:
- Lifestyle modifications, such as regular physical activity, a healthy diet with reduced sodium, and weight management if needed
- Proper diagnosis to identify any underlying causes of hypertension
- Close monitoring of blood pressure and potential side effects
- Adjustment of medication as needed to achieve optimal blood pressure control By following these guidelines and considering the individual needs of the patient, healthcare providers can effectively manage hypertension in 15-year-old adolescents and reduce the risk of long-term cardiovascular complications 1.
From the FDA Drug Label
The antihypertensive effect of losartan was studied in one trial enrolling 177 hypertensive pediatric patients aged 6 to 16 years old. The antihypertensive effect of lisinopril was seen with 5 mg of lisinopril in some patients In a clinical study involving 115 hypertensive pediatric patients 6 to 16 years of age, patients who weighed < 50 kg received either 0.625 mg, 2.5 mg or 20 mg of lisinopril once daily and patients who weighed > 50 kg received either 1.25 mg, 5 mg, or 40 mg of lisinopril once daily.
Antihypertensive medications that can be prescribed to a 15-year-old adolescent with hypertension are:
- Losartan: The dosage for pediatric patients aged 6 to 16 years old is based on weight, with patients weighing <50 kg receiving 2.5 mg, 25 mg, or 50 mg daily, and patients weighing ≥50 kg receiving 5 mg, 50 mg, or 100 mg daily.
- Lisinopril: The dosage for pediatric patients aged 6 to 16 years old is based on weight, with patients weighing <50 kg receiving 0.625 mg, 2.5 mg, or 20 mg daily, and patients weighing >50 kg receiving 1.25 mg, 5 mg, or 40 mg daily. 2 3
From the Research
Antihypertensive Medications for Adolescents
The following antihypertensive medications can be prescribed to a 15-year-old adolescent with hypertension:
- Angiotensin-converting enzyme inhibitors 4, 5
- Angiotensin receptor blockers 4, 5
- Calcium channel blockers 5, 6
- Thiazide diuretics 7, 5
Considerations for Medication Use
When prescribing antihypertensive medications to adolescents, considerations should include:
- Lifestyle changes, such as weight loss, healthy diet, and regular exercise, as first-line treatment 4, 5
- Evaluation for underlying medical disorders and comorbid cardiovascular diseases 5
- Monitoring for cardiovascular damage with echocardiography 5
- Potential risks and benefits of medication use, including effects on cardiovascular risk factors and target organ damage 7, 4, 5
Evidence for Medication Efficacy and Safety
Studies have shown that these medications are effective and safe for use in adolescents with hypertension:
- Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to reduce blood pressure and target organ damage in children and adolescents 4
- Calcium channel blockers, such as amlodipine, have been found to be effective and safe for use in hypertension, with strong evidence for cardiovascular event reduction 6
- Thiazide diuretics have been used as first-line antihypertensive agents, with evidence of efficacy and safety in adults and children 7, 5